Restrictive Practice | Nursing

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Introduction
The term restrictive practice, when it comes to mental health service, refers to any type of
practice or support that limits the freedom of movement and basic right of a person with mental
issues. In Australia, seclusion is one of the most vaguely used restrictive practices in order to
manage as well as treat heath care service users with mental illness. Since 1993, several concerns
have been highlighted with the usage of restrictive and coercive practices in the Australian
mental health services, specifically on the practice of seclusion. Various researchers have
pointed out the adverse impact of seclusion and restraining practice on the patient and how these
practices hinders the recovery of the patients. While, with the advancement in technology and
partly due to recent movement by the consumer groups of Australian mental healthcare services
for restricting restrictive practices, the rate of usage of seclusion and restraining practices on
mental health service users have reduced slightly. However as per the data obtained from the
Australian Institute of health and welfare (2018-19), approximately 12000 cases have been
evidenced in Australian mental healthcare services. In order to reduce the restrictive and coercive
practice, it is highly crucial to understand the impact of seclusion and restrain on the consumer
and health professional and the role of the registered nurses to effectively reduce the practices. In
the following paragraph a detailed critical discussion on the impact of seclusion and restrain on
the consumer and health professionals has been conducted. Additionally, critical evaluation of
the health professional and the role of the registered nurses in collaborating with the consumers
to work towards State/Territory and National initiatives to effectively reduce the practices has
also been discussed bellow.
Discussion (1600)

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Impact of the seclusion and restrain on the consumer and health professional
It has been clearly stated in the Mental Health Act 2009, restraining and seclusion
practices are not therapeutic interventions. While retraining practice includes usage of
physical force, mechanical devices or chemical for immobile the patient, seclusion, also a
type of restraining practice includes confining the patient from which he or she cannot
exit freely.
Therefore, as per the restraint and seclusion in Mental Health Services Policy Guideline,
restrain and seclusion should be used as the last resort by health professional when all the
other option for managing the patient failed and for the need of ensuring safety of the
patient, his or her family members as well as healthcare service providers. The chief
reason behind considering the process of seclusion and restraining to be the last option to
manage the mental patients is that this practices possess the potential is to impose a good
number of negative impact on the mental as well as physical health of the patient and thus
can worsen his/her mental condition.
Andersson and Palm (2017) have stated that one of the major impacts of seclusion on patients
with metal issue is trauma leading to severe depression, anxiety, self injury and even suicidal
activities. Keeping the patients alone in a separate room makes in majority of the cases
enhances the feeling of distress during the time of restrain. Being restrained physically, possess
high potential to bring back the memories of previous truma experienced by the patient and ths
can leads to retraumatising. This may amplify the urge of conducting aggressive behaviour and
self harm. According to Quinn et al. (2019), both seclusion and restrain puts patients at the risk

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of self injury and even death. These practices are majorly considered to be anti recovery since
majority of time they make the patient fearful of their future treatment.
However, according to Chieze et al., (2019), the impact of seclusion is highly dependent on the
ward environment. Considering the fact in the process of seclusion, it has been seen that patients
who were provided with multi-bed rooms and kept secluded with other secluded patients exhibits
lower coercion compared to patients who are kept in single rooms. The chief reason behind this
is lack of communication enhances the likeliness of getting irritated, anxious as well as
depressed. However, Santangelo, Procter and Fassett (2018) have argued that, in order to ensure
safety of the patients, several healthcare organizations in Australia prefers separated seclusion
for patients with mental issues like Schizophrenia. The chief reason behind this is, in 82 percent
of the cases, patients demonstrate unpredictable aggressiveness and frustration. In case patients
are kept together, there is an increased risk of harming one another and this in turn will impose
negative impact on both physical as well as metal heath of the patients.
Spicer and Burton (2019) have pointed out being a vaguely used practice to deal with aggressive
patients suffering from metal issues in aUstrlai, seclusion ad restraining practice leads to
dehumanization of the patients. This means, patients after being restrained are often left in
adverse situation like lift in urine soaked cloths which enhances their feeling of being
“subhuman”. It also makes them feel helpless, worthless and enhances the urge of self harm and
suicidal tendencies. In several cases, unnecessary and excessive forces are used for restraining
metal health patients which in turn demonstrate lack of empathy. This in turn creates a
perception of the patients that they are being punished unjustifiably for being ill and this in turn
also leads to feeling of being powerless. Helpless, abused. Ross (2018) stated that forceful
restrain and seclusion impose highly negative impact on the self esteem of the patients In such