Essay | Effects of Seclusion on Healthcare Personnel

Running head: ESSAY
Assignment topic 2
Name of the Student
Name of the University
Author Note
Word count- 2157

ESSAY1
Introduction- A mental illness is typically any health condition that brings about an
alteration in the feelings, thinking and behaviour of people, thereby leading to difficulty and
distress in functioning. Mental health encompasses the psychological, emotional and social
wellbeing of people and also facilitates determination of the manner in which they cope with
life stressors, associate with others and participate in making decisions (Worden, 2018).
Taking into consideration the perspectives of holism, mental health generally encompasses
the capability of a person to strike a balance between different activities of life and efforts
that help in attaining psychological resilience. A restrictive practice generally refers to any
practice that creates a significant impact by limiting the freedom or right of movement of an
individual with disability, with the chief objective of safeguarding the individual from harm
(Sustere & Tarpey, 2019). Also referred to as restrictive interventions, these practices are
typically authorised for usage as a significant part of behaviour support for a person, in order
to ensure that individuals are supported safely. This essay will critically evaluate the effects
of seclusion on healthcare personnel and consumers, in addition to highlighting the role of
registered nurses (RNs) in decreasing restraint use and seclusion.
Legislation regarding restrictive interventions- The restrictive practices typically
include seclusion, use of restraint, and fast tranquilisation. In addition, the interventions often
prevent patients from accessing outside spaces. The Mental Health Act formulated and
enforced in 2014 places individuals suffering from mental disorder at the core of decision
making, in relation to their care and treatment (Victoria State Government, 2014). The act not
only encourages mental health practitioners like psychiatrists to foster strong association with
the consumers of mental health services, but also promotes offering support and adequate
information for making informed care choices. The act also highlights the importance of
voluntary treatment, in place of compulsory treatment, apart from safeguarding the dignity,
rights and autonomy of people with mental disorder. One core principle of the act is that

ESSAY2
evaluation and treatment are delivered to people with mental illness in the least invasive and
restrictive approach. The directive of restrictive interventions is applicable to all individuals
who seek help from mental health services, notwithstanding the legal status or age of the
person under the Mental Health Act. Furthermore, the act makes it imperative for the
Victorian Government to display a commitment towards decreasing wherever conceivable,
the usage of restrictive interventions in mental health (Ross, 2018). Thus, following the rules
set out in the act, restrictive intervention application needs to be sanctioned by an authorised
psychiatrist or delegate, or a registered medical practitioner (when the former is not
available).
Impact of restraint and seclusion- Restraint is of different types like physical,
environmental or chemical. According to Burry, Rose and Ricou (2018) while physical
restraint involves placing a material or device near the body of the patient that cannot be
easily removed or controlled, chemical restraint focuses on the use of medications that are not
usually a component of the treatment regimen, and are used for controlling the behaviour of
the patient. Seclusion has been identified as a form of environmental restraint and the patient
is confined in a region with shut doors and windows to prevent their exit from the region,
thus imposing restrictions on free movement (Colaizzi, 2016). For several patients, being
physically restrained triggers the onset of reminiscences about previous instances that might
have been responsible for their mental illness, and are described as re-traumatising. These
practices have often been associated with the onset of post-traumatic stress disorder amid
patients (Morrissey & Collier, 2016). Eventually, the restraint is often perceived by patients
as ‘anti-recovery’, thereby making them apprehensive of upcoming treatment modalities
(Brophy et al., 2016). The poor condition in which patients are left at the time of restraint is
dehumanising and also leads to the onset of feeling of being ‘subhuman’, as a direct outcome
of being controlled. A number of patients who are subjected to restraint also report the belief

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that application of extreme force used by the healthcare staff demonstrates that the latter lack
any kind of compassion or empathy towards the patients (Holden, 2017). Subsequently,
several patients also have the perception that while using restrictive practices, the staff are
generally punishing them and applying influence over them, thereby leading to an emotional
state characterised by helplessness, vulnerability, worthlessness, losing control, being ill-
treated, guilt and low self-esteem (Lintner & Elsen, 2018). According to Payne-James (2016)
restraint also has severe physical consequences like bruises, strangulation and increased
mortality due to serious injuries. In elderly patients who are subjected to restrictive practices,
the physical symptoms are compounded with respiratory complications, decubitus ulcers,
impaired muscle strength, under nutrition, and reduced cardiovascular endurance.
As claimed by Rose et al., (2017) being subjected to restrictive practices often leads to
the generation of feelings related to distress and suffering during the entire treatment
procedure, and even after the treatment is over. Those patients who have been secluded or
restrained generally report tension, rage and fear, and are not able to adjust to the care
settings, eventually suffer from troubling or confusing experiences. Not only do they become
fearful of the healthcare staff, but also start manifesting hostile and aggressive behaviour. At
the core of seclusion and restraint is the subject of power (Kinner et al., 2017). For most
patients, this is generally professed as an unnecessary or unmannerly usage of supremacy,
whereby the healthcare staff exhibit authority over the patients. This in turn results in
potential breach of human rights since keeping patients under control or governing their
course of action interferes with their freedom of movement (McCarthy, 2018).
Healthcare staff often reported that the choice to implement seclusion and restraint on
patients diagnosed with mental illness was generally difficult, and they most often felt
conflicted about their involvement. Nonetheless, the staff express a complete positive outlook
about usage of the measures owing to the fact that they do not have access to any better