Essay on Mental Health 2022

Running head: MENTAL HEALTH
Mental health
Name of the student:
Name of the University:
Author’s note

1MENTAL HEALTH
Restrictive practices or coercion measures are some mental health interventions used in
extreme circumstances to control extremely aggressive patients. Coercion is mainly defined as
the use of any intervention against a person’s will, whereas restrictive practices involve
confining or restricting a person’s freedom by either confining them in a room (seclusion) or
restricting patients’s independence by immobilization techniques (restraint). The main purpose
behind the use of this intervention is to contain aggressive behaviours (Australian Institute of
Health and Welfare, 2019). However, due to the overriding of a person’s will and violation of
human rights of autonomy, liberty of choice and physical integrity, there has been an
international movement against eliminating or avoiding use of restrictive practices in the mental
health setting (Chieze et al., 2019). Controlling seclusion became a legal obligation too as in the
year 2015, the Mental Health Act Code of Practice mandated all mental health services to
decrease use of restrictive practices. This action was taken after identifying possibilities of
reducing restrictive practices (Care Quality Commission, 2020). Thus, with such emphasis on
preventing this practice, the main purpose of this essay is to critically discuss and interpret the
impact of seclusion to consumers and health care professionals. In addition, the essay will look at
registered nurse role in collaboration with consumes to work towards national initiatives in
reducing seclusion. The essay will look at physical and psychological factors affected by use of
seclusion and consider the impact of the practice on mental health professionals.
Currently, there is national and statewide drive to implement new initiatives and practices
so that seclusion is avoided or prevented by all means. As seclusion has become a movement by
both consumer groups as well as mental health care professionals, this paragraph will look at
how seclusion influences consumers and health care professionals alike (Ramluggun, Chalmers
& Anjoyeb, 2018). In the context of patients, the main issue is that seclusion leads to both

2MENTAL HEALTH
physical and psychological harm. Chieze et al. (2019) gave evidence for deleterious physical or
psychological consequences of seclusion. Seclusion is employed in patients with schizophrenia
and manic disorders and patients going through these experiences have mainly suffered from
negative emotions like feelings of distress and punishment. Other examples of deleterious effect
are the revival of previous traumatism, post traumatic stress disorder, longer hospital stay and
negative emotions. A study by Ye et al. (2019) reported about the impact of physical restraint. It
is a practice used for alleviation of conflict, physical assault and mental trauma. However, other
harmful effects of physical restraint on patient is that it causes unexpected physical injury to
patients such as skin injury, pulmonary disease, nervous system damage, ischemic lesions and
sudden death. Moreover, they suffer from physical restraint too such as lack of self-esteem,
extreme feelings of depression, hopelessness and low quality of life. Kinner et al. (2017) show
strong agreement across participants group regarding the harmful effects of seclusion. The study
reported strong agreement across participants group regarding the fact that restraint is harmful,
leads to violation of human rights and compromises therapeutic relationship between staffs and
patients.
In contrast to the patients, there are many challenges for health care staff in using
seclusion. For example, due to extreme burden associated with the process of seclusion or
restraint, mental health staff often applies for sick leaves. Many staffs threat using this in mental
setting because of moral conflict associated with the decision and previous experience of
suffering extreme trauma or injury during the process (Ye et al., 2019). Another major issue for
psychiatric inpatient wards or mental health staff is that there is ethical issue associated with
seclusion in psychiatric wards too. The study by Haugom, Ruud and Hynnekleiv (2019) give
insight into various ethical challenges associated with the use of seclusion by evaluating

3MENTAL HEALTH
experiences of Norwegian mental health professionals. For example, the staffs reported about
psychological strain because of ethical decision making challenges. Sense of ambivalence and
unrest was common among participants because of violation of self-determination rights and
autonomy of patients. They are always in a dilemma whether to give preference to safety risk
associated with aggression and patient’s inherent right to freedom or choice. The staff also
expressed the concern that many patients have verbally expressed their feelings through their
actions and strongly disagreed to seclusion as treatment (Haugom, Ruud & Hynnekleiv, 2019).
Thus, this further shows how use of seclusion is associated with threats and sense of insecurities
for health care staffs too.
To further understand ethical decision making challenges, there is a need to compare the
coercive practice with the four ethical principles of autonomy, beneficence, justice and non
maleficence. Zheng et al. (2020) argue that seclusion not only causes negative traumatic
experience, but also causes depression and panic among patients and medical care personnels.
The feelings of sense of distrust on patients are a common concern and the main reason behind
this is that several ethical considerations are violated during the procedure. For example, one of
the ethical responsibilities is to protect patient’s autonomy by protecting patients from getting
hurt (Heale & Shorten, 2017). In situations when aggression threatens safety of others, patients
are often asked to compromise individual autonomy and give preference to protection over
autonomy. However, the significance of the study is that it gives idea about the certain strategies
that could have been used to minimize the impact. For example, nurses could take informed
consent from next of kin if patients refuse seclusion. This makes sense as mentally ill patients are
often incompetent to take correct decisions (Al-Maraira & Hayajneh, 2018). Moreover, one
argument against the use of seclusion is that it violates the ethical rights of justice by robbing