Reduction of Seclusion and Restraint in Mental Health Services Essay

This essay examines the reduction of seclusion and restraint in mental health services, focusing on the perspectives of consumers and healthcare professionals. It explores the negative consequences of these practices, including human rights breaches, trauma, and compromised therapeutic relationships. The essay delves into the roles of nurses in minimizing seclusion and restraint, highlighting strategies such as improved training, communication, and the implementation of evidence-based models like Safewards. It emphasizes the importance of patient-centered care, empathetic approaches, and team management to create a safer and more supportive environment. The conclusion underscores the availability of various treatment procedures, including community and private mental health services, psychological therapies, and medications, while advocating for the use of seclusion and restraint as a last resort.

Running head: REDUCTION OF SECLUSION AND RESTRAINT SERVICES
REDUCTION OF SECLUSION AND RESTRAINT SERVICES
Name of the Student
Name of the University
Author Note

1REDUCTION OF SECLUSION AND RESTRAINT IN MENTAL HEALTH SERVICE
Introduction
Mental illness, most commonly known as a mental health disorder, is a medical condition
of a person that affects a person's thinking ability, feeling, behavior, and mood. Some examples
of the mental disorder include anxiety, depression, schizophrenia, eating, and behavioral
dysfunction. In Australia, mental illness is a widespread symptom, and the prevalence of this
disease is most in mid to late adolescence and among the age between 18-24. The study report
said that the age group from 16 to 85 years, 7.3 million Australians experience a mental disorder
in a year (Commonwealth of Australia | Department of Health, 2020). The most common
complication in Australia is an anxiety disorder, substance use disorder, and depression. The
statistical data showed that 54% of the populations with mental illness do not undergo any
treatment procedure. Approximately 75% of people access public mental health services for their
treatment (facts and figure about Mental Health, 2020). Varieties of treatment procedures are
available to care for the patient. Health professionals support the mental health patient by
providing community mental health services, private health services, different psychological
therapies, and also some medications such as antipsychotics, antidepressants, and mood-
stabilizing drugs. Seclusions and restraint are also used in many mental health services in
Australia. This paper discusses the seclusions effect in the patient and professionals, even the
role of nurses interconnected with consumers for the reduction of seclusion and restrains.
Discussion
Various treatment procedures are present to handle the mental illness client. Recent
studies stated that coercive practices have a significant influence on providing mental health

2REDUCTION OF SECLUSION AND RESTRAINT IN MENTAL HEALTH SERVICE
services. Consumer responses varied rapidly in obtaining the services as cultural factors involved
in this. The study reported that African-American consumers experienced a low level of coercive
practices compared to Latinos and Whites. They were treated differently from others. The study
results suggested that the consumer did not consider the low-end coercive strategies as coercion
(Luciano et al., 2014). The absenteeism of a connection between strategy utilization and received
pressure noted that consumers interpreted the behavior of caregivers differently.
Consequently, the relationship is dependent upon the users' perception of coercion
regardless of the caregivers' behavior. The study also revealed the negative relationship persists
between caregiver-consumer relationships and observed constraints (Theodoridou et al., 2012).
Coercive practices are always a part of mental illness treatment procedures. Although, the ethical
issue between the coercion method and the client's self-esteem loss raised a controversial topic in
mental health service. Researchers have seen that sometimes the restrictive practices have
positive outcomes and occasionally harmful. The relationship between users' outcome and
coercion practices is controversial. The related factors involved to measure the coercion include
consumers' clinical characteristics, socio-demographic data, employee characteristics, and ward
related-issue.
The use of seclusion or restraint behavior indicates a controversy both the consumer and
health professionals. Participants consider this practice in different ways. The harm caused by
this seclusion includes breach of human rights, negotiating therapeutic approaches, and
stimulating the past traumatic events. Some participants perceive this behavior as advantageous
since it sometimes protects the staff and other individuals, enhances consumer safety. The
majority of the users reflect on eradicating the method. They think it as both reasonable and

3REDUCTION OF SECLUSION AND RESTRAINT IN MENTAL HEALTH SERVICE
desirable to remove the chemical and emotional restraint while others analysis was to eliminate
the process of seclusion.
In contrast, professionals considered it as beneficial since seclusion and restraint are
regarded as necessary restrictive interferences to unusual behaviors. They overview this process
through their occupational health and safety (Kinner et al., 2017). Another study was carried out
by Taylor et al. (2012) to investigate who is more susceptible to multiple seclusions or restraint.
They found that males with aggression and cognitive impairment had an elevated chance of
coercion.
In Australia, among the entire populations, 2-3% have severe mental disorders (Brophy et
al., 2016). Seclusions and restrains are new interferences that are currently performed in
psychiatric treatment to cure them. Seclusion is well-defined as considering the quarantine of an
individual alone in an area or room. Under this condition, the consumer is not allowed to go
outside without permission. Restraint described the procedure of physical forces or a device to
manage the peoples' liberty of movement. It may include the medication practice that means
chemical restrain to regulate the clients' behavior rather than treating mental disorders. After
experimenting with examining the effect of restrain and seclusion with ten focus groups, several
factors appeared from the investigation. The first concern was human rights. The consumer
reported these interferences as a human rights breach. Although they had necessary to control the
risk, the performed seclusion and restrains may also influence trauma, and this trauma can again
bring back to them in the previous condition.
Moreover, this obtained trauma hurts the recovery of the consumers, creates a trust issue,
and the relationship with service providers. It is seen that restrain and seclusion is frequently

4REDUCTION OF SECLUSION AND RESTRAINT IN MENTAL HEALTH SERVICE
used to control the clients. Nonetheless, the variation is observed for ethnic and linguistically
diverse cultural societies. This community is unable to understand what is being done on them.
The isolation is another main issue that can affect them severely. It is specially performed for the
indigenous community. Seclusion has been suggested as a barrier and termed as anti-recovery
since it affects mental health in the long term rather than curing the users. From this analysis, it is
observed that the seclusion and restrain practice has poor outcomes and harms them as well as
their supporter (Brophy et al., 2016).
Seclusion and restrains have a negative consequence and should be used as the last
remedy. After practicing these techniques on mental illness patients, it adversely affects them,
especially with Post Traumatic Stress Disorder (PTSD). The subjective effect of seclusion was
considered safe and secure and somewhat necessary that was revealed in some studies. Some
studies reported that consumers felt relieved after isolation and had a positive response to
obtaining constant support and care from the patient (Chieze et al., 2019).
Another survey was conducted to reveal the perceptions of mental illness service
providers, consumers to the seclusion, and restrain practice in treating mental health disease. The
study showed that consumers were the worst sufferer of this method and regarded this
detrimental to their health. They believed that these practices breached human rights,
compromised the therapeutic relationships, and hamper the trust between the patient and
therapist. Alternatively, professionals considered this method as advantageous to them in some
ways, such as providing safety to the assigned working staff, increased safety to other
consumers, and created behavioral boundaries (Gerace & Muir‐Cochrane, 2019).
Role of nurses in decreasing seclusions and restraint:

5REDUCTION OF SECLUSION AND RESTRAINT IN MENTAL HEALTH SERVICE
The practice of seclusions and restrains has detrimental effects on psychological as well
as physiological health. Seclusion and restrains are mostly interrelated with negative sensations
among the patient also somewhat in the health care providers. These techniques should be used
as a last resort of management to the patient. Nonetheless, these techniques are widely followed
by nurses and other care providers because of several factors. In light of this position, the
American Nurses Association (ANA) has proposed that registered nurses should participate in
reducing patient seclusion and restraint in the health care system. ANA has suggested that there
is a lack of adequate personnel to monitor the patient, and the absence of less restrictive methods
have elevated the choosing of this restrains and seclusion methods (American Nurses
Association, 2020). This association considers that the restraint method should be used only
when no other option will be present. When the restraint is needed, the registered nurse should
play a significant role in documenting this by more than one observer. The National Mental
Health Consumer & Carer Forum (NMHCCF) had played a vital role in reducing restraint and
seclusion. They introduce some strategies to end this approach. The first is better accountability,
which includes a national plan for decreasing mischief to patients. It involves different methods
to eliminate this in Australia. The advisory committee associated with the implementation of
these techniques includes the Australian Government, Mental Health Standing Committee, and
the Australian Health Ministers Advisory Council (AHMAC). The second consideration is
related to the implementation of an evidence-based practice attitude to removing this method
(Grove & Gray, 2018). In this matter, a registered nurse can play a significant character in
applying this. They can perform efficiently as it is related to their work, and they can evidence
the entire experiment thoroughly. The NMHCF introduced a pivotal policy to reduce this
restraint and seclusion. They suggested that regular monitoring and application of new clinical

6REDUCTION OF SECLUSION AND RESTRAINT IN MENTAL HEALTH SERVICE
standards should be performed carefully. In this matter, the psychiatric nurse should follow the
Australian Competency Standards for the Registered Nurse and other measures. Each nurse
should register and follow the correct professional and competency practice in association with
care planning. They should consider and abide by the responsibilities, roles, and accountabilities
when practicing seclusion and restraint (Ending Seclusion and Restraint in Australian Mental
Health Services, 2020). The nurse should evaluate the necessity of the techniques before
performing on the patient. It can reduce the practice of these methods in some ways. The
introduction of proper training, education, advanced communication; conflict resolution skills
would support them in decreasing these methods (Varcarolis, 2016)
A study reported that restrictive procedures are followed in reaction to aggression and
conflict in mental health settings. A new model has been proposed to decrease these inpatient
services. The survey revealed that Safewards intervention was effective in adult and adolescent
patients in mental health care. The nurses performed a significant role in implementing this
model. Training program, survey analysis, sufficient knowledge, checklist, and focus on the
consumer effect; motivation for work has supported them to achieve this in clinical practice.
Consequently, they can minimize the seclusion practice in the clinical environment (Fletcher et
al., 2017).
There is a necessity to take some initiatives in seclusion and restraint reduction program.
These invented some applications such as leadership, training program, therapeutic environment,
post-seclusion and restraint feedback, prevention tools, and patient involvement. Among them,
the nurses have a role in the training program. Training on de-escalation techniques, changed o
their philosophical view, has reduced the performing of this action (Hercelinskyj & Alexander,
2018). The nurses can opt for motivational interviews of their clients' to overcome this inhuman

7REDUCTION OF SECLUSION AND RESTRAINT IN MENTAL HEALTH SERVICE
practice (Miller & Rollnick, 2012). The introduction of the leadership program has a beneficial
role in this case. Since the organization has revised the rules and regulations and changed its
protocols to serving the patient, the nurses should abide by them. It, in turn, will decrease this
kind of action (Goulet et al., 2017).
Another survey was performed to reduce restraint activities. Several methods are
followed to minimize the restraint, and other tools and processes were implemented. A safety
plan was introduced to help to detect the risk of aggression and violence. It was also applied to
promote awareness and effective communication among the medical staff to learn how to treat a
patient. The involving nature of the RY implementation creates an argument and decreases fears
of the team, and enhances attitudes and beliefs about restraint diminishing. Health authorities are
stated to adopt new person-centered care and empathetic approach of caring. A team
management approach controlled violence and aggression. This commitment increased
confidence among them. It also helped in minimizing the seclusion and restraint strategy. The
nurse also creates a positive environment to reduce this action (Duxbury et al., 2019).
Conclusion
In conclusion, it can be inferred that varieties of treatment procedures are available to
care for the patient. Health professionals support the mental health patient by providing
community mental health services, private health services, different psychological therapies, and
also some medications such as antipsychotics, antidepressants, and mood-stabilizing drugs.
Seclusions and restraint are also used in many mental health services in Australia. It is
extensively followed. The study results suggested that the patients did not consider the low-end
coercive strategies as coercion. The study also revealed the negative relationship persists

8REDUCTION OF SECLUSION AND RESTRAINT IN MENTAL HEALTH SERVICE
between the caregiver-patient contact and observed constraint. Seclusion is identified as a barrier
and termed anti-recovery since it affects mental health in the long term rather than curing the
patient. Seclusion and restrains has a negative consequence and should be used as the last
remedy. After practicing these techniques on mental illness patients, it adversely affects them,
especially with Post Traumatic Stress Disorder (PTSD). The subjective effect of seclusion was
considered safe and secure and somewhat necessary that was revealed in some studies. Some
studies reported that patients felt relieved after isolation and had a positive response to obtaining
constant support and care from the patient. The nurse has a significant role in preventing the
seclusion and restrain method. Another survey was performed to reduce restraint activities.
Several ways are followed to minimize the restraint, and other tools and processes were
implemented. A safety plan was introduced in detecting the risk of aggression and violence.

9REDUCTION OF SECLUSION AND RESTRAINT IN MENTAL HEALTH SERVICE
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