Restrictive and Coercive Practices in Mental Health Essay

This essay critically examines restrictive and coercive practices within mental health settings, focusing on seclusion and restraint. It explores the impact of these practices on both patients and healthcare professionals, drawing on national and international perspectives. The essay delves into the detrimental effects of restrictive measures, including violations of human rights and the trauma experienced by patients, while also investigating the role of the registered nurse and the Safewards model in promoting person-centered care and reducing the need for restrictive interventions. The discussion highlights the importance of consumer perspectives, the impact of emotional restraint, and the need for comprehensive approaches to improve mental health care delivery, emphasizing the role of Safewards in fostering a safer and more therapeutic environment. The essay concludes by advocating for efforts to reduce restrictive practices and promote recovery-oriented care.

Running head: HEALTHCARE
HEALTHCARE
Name of the Student:
Name of the University:
Author note:

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Introduction
In Australia as well as globally, there has been witnessed a programme led by
consumers as well as carers further advocated by national plan to decrease seclusion as well
as restrictive practices in Australian mental health facilities (Baumgardt et al., 2019). The
principal of recovery coordination has relied to the reality that consumers whether or not
suffering from signs of mental disorder have been significant in setting their individual
urgencies for care as well as obtain the required sustenance to live an important life. The
operations of the United Nations Convention on the Rights of Persons with Disabilities in
2008 has strengthened the programmes and practices which focus on reducing seclusion and
restrictive practices. According to Hercelinskyj and Alexander (2019), seclusion and restraint
are known as interventions in the domain of clinical practices which are at present authorized
to use in providing mental health facilities as well as other segments in order to regulate or
deal with behavioural patterns of individuals. The term ‘seclusion’ typically refers to the
cautious quarantine of an individual in a particular room or area in order to restrict the
person’s exit from that space. While, the word ‘restraint’ tend to take into account the
utilization of physical force such as physical restriction or any kind of method to regulate
individuals’ freedom of movement such as mechanical restraint in addition to the medicinal
usage for controlling behavioural pattern of individual instead of treating a mental disorder or
chemical restraint (Ash et al., 2015). The thesis of the essay is “there is a robust agreement
claiming that the use of seclusion as well as restraint can be destructive due to violations of
human rights and the trauma which people experience due to this seclusion and effective
measures can aid services to reduce the need to use these practices.”
Discussion
The impacts of seclusion to consumers and healthcare professionals alike

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In Australia, the six federations along with two regional administrations subsidize and
provide public sector mental health facilities which offer specialist treatment for consumers
suffering from critical mental health problems. As per reports, it has been accounted that
around 2-3% of Australians which can be estimated for nearly 600,000 inhabitants have
diagnosed critical mental disorder which involves high levels of depression, anxiety or
psychosis. On the other hand, around 0.5% of the population suffering from certain forms of
psychotic disorder which is typically is diagnosed as schizophrenia. However, severe
apprehensions about the practice of seclusion as well as mechanical restriction in mental
health settings have been upraised since 1993 (Brophy et al., 2016). Furthermore, there has
been found contrary findings by researchers on severe harms which have been caused due to
the restrictive practices. On the other hand, concerns have been shown regarding levels of
deprivations of liberty, intervention with individual honesty in addition to the loss of self-
respect.
A number of research have noted hostile costs for those exposed to seclusion as well
as mechanical restraint and upturned apprehensions of human rights breaches (Prophy et al.,
2016). Meanwhile, wide range of studies have illustrated adverse costs for clients who have
been positioned on the receiving end of seclusion and restrictive practices and have thus
upraised distresses regarding human rights breaches (Fletcher et al., 2019). In the view of
Bowers et al. (2015), majority of discussion tend to shed light on the desire and appeals of
consumers want to understand an effective decrease in the practice of seclusion and
restrictive practice due to the severe trauma and distress the practice causes. As a result,
consumers in the Australian mental health care setting do not perceive restrictive practice to
be acceptable and correct. Patients along with their supporters like families, friends in
addition to other associates recently have been raising concerns regarding the severe
‘emotional restraint’ consumers are receiving.

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The impact of restrictive practices on consumers develops a feeling of constriction in
voicing their opinions in a direct and honest approach to the practitioners or nursing
professionals due to the fear of the consequences (Scanlan & Novak, 2015). Additionally,
emotional restraint in this stage has been associated with the pressures of abiding the
behavioural potentials. At this juncture, Schulz (2019) has indicated that individuals who
have been labelled with mental disorders face immense bias and discernment similar to the
experiences encountered by other devalued groups. Since the term ‘stigma’ is typically used
for the experiences encountered by consumers, the term indicates the term cites the problem
as within the individual (Brophy et al., 2016) Thus, in order to neutralize emotional
restriction, prejudice in addition to discernment, it is highly crucial that the standpoints of
consumers in addition to their supporters are proclaimed in addition to acknowledged in the
mental health system which might further be grounded as much on pressure as care.
Recent reports have claimed that experiences of consumers due to restrictive practice
have been extremely undesirable and destructive further linked to the direct intensification of
suffering, anguish and penetrating feelings of despair, humiliation, fear and fury. On the other
hand, Fletcher et al. (2019) have claimed that in comparison to professionals, consumers have
been of the opinion that lessening or removal of restrictive practices will be more desirable
and practicable. Furthermore, consumers as compared to nursing professionals or carers tend
to show greater likelihood to consider that restriction and control causes harms. Wahlbeck
(2015) has claimed that the injuries and harm caused by seclusion and restrictive practices
give rise to forceful treatment experienced by consumers. Such impact has been seen as an
unprotected expression of the weakness and subjection of consumers.
Moreover, consumers across Australia have exhibited similar concerns related to the
negative impacts caused by restrictive practices. The harms have been viewed to be causal
effect of deliberate efforts of extreme force, segregation in addition to the violation of human

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rights, chiefly in terms of the loss of dignity (Fletcher et al., 2017). Furthermore, these harms
have beheld as venerable for consumers as well as for supporters and typically re-
traumatising.
In contrary, studies have shown that healthcare professionals tend to show greater
levels of probability as compared to consumers to recognize benefits related to restrictive
practices (Wand, 2015). Such opinions have illustrated a link of safety and improved
behavioural patterns. Through a perspective of occupational health as well as safety, it has
been noted that restrictive interventions tend to provide essential answer to the behaviours of
concern. Recent research has shown that majority of nursing professionals had been engaged
into higher level of seclusion, physical restriction in comparison to mechanical restraint,
authorizing current clinical practice with mental health clients (Gerace & Muir‐Cochrane,
2019). As a result, the criticality of restraint has been supported in the situation of unsafe
situations, although in the form of a last alternative of safeguarding consumers as well as
staffs.
Meanwhile, studies have revealed that nursing professionals tend to exhibit no
challenges in making decisions related the use of suppression and restrictive methods (Goulet
& Larue, 2016). Additionally, nursing professionals perceive restrictive methods as effectual
to deal with severely critical mental health patients. Conversely, lack of adequate skills in
treating severely ill consumers has been observed to upsurge the possibility of practicing
containment measures. Thus, it has been highly imperative to take into account whether lack
of effort in deciding practicing seclusion and restrictive practices has been determined by
decision related to most applicable mediation, or whether additional knowledge development
or teaching is necessary in dealing with conflict besides using alternative treatment
approaches in mental health domains (Kinner et al., 2017). While, the impact of restrictive
practices have been harmless for nursing professionals, there has been a consensus that they

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do not certainly consider the practices to be justifiable or favourable, but essential for
preserving a nonviolent and safe work setting.
The role of the registered nurse (RN) and Safewards in collaborating with consumers
The complex interplay between espoused commitments by government and a
tolerance of restrictive practices have supressed the professional determination of RNs in
delivering person-centred care approach in the mental health setting. Maguire et al. (2018)
have claimed that there have been observed extreme levels of challenges in treating clients
suffering from mental illness. These services tend to highlight medication observance in
addition to the risk management. These factors have caused in RN’s not receiving adequate
amount of time and self-sufficiency to involve in therapeutically establish important
connections with clients (Muir‐Cochrane et al., 2018). Hence, there has been an increasing
level of frustration for consumers as well as RNs.
However, by drawing relevance to these factors, there has been identified a need for
implementing comprehensive model of practice which can shed light on highly effective and
available evidences. These evidences have the capacity of highlighting activities which
comprises of the most appropriate nursing training in mental health settings. Thus, the
Safewards model as well as interventions has offered important scopes of focusing on the
need of improving this situation and put efforts towards State or Territory as well as National
initiatives in reducing seclusion and restraint. Reports have revealed that by drawing insights
of the effective RCT results gathered from the United Kingdom, the Victorian Department of
Health in 2013 in Australia have subsidized self-selected health facilities with an agenda of
applying Safewards all through the 18 divisions in urban as well as regional Victoria (Oster et
al., 2016).
As per studies of Wilson, Hutchinson and Hurley (2017), the Safewards model has
proficiently recommended six devising domains related to the supporters of consumers,

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patient attributes, supervisory structure, employee units in addition to healthcare setting as
well as outside hospitals. These domains show high possibility of contributing to flashpoints
such as a situation that might give conflict linked to physical harm and resulting in restraint
of consumers. Nursing professionals however in this stage have the prospective to moderate
each of these mechanisms of the model by setting up base for interactions with consumers.
Meanwhile, Hottinen et al. (2019) have claimed that with the lack of any comparable quality
of evidence on what has made mental health settings relatively safer place for RNs,
Safewards interventions can be implemented on adult acute mental health services.
According to comprehensive studies, through positive approach of Safewards, nursing
professionals as well as consumers experience equivalent association. Thus, RNs tends to
exhibit high positivity towards Safewards, thus have been supporting the legitimization and
operation of Safewards model as the supremacy of person-centred care. With effective
implementation of Safewards, nursing professionals tend to experience augmented level of
job satisfaction. Such level of work satisfaction has been rising gradually as RNs have been
able to spend additional time to establish direct and honest interactions with their consumers
seeking mental health services (Väkiparta et al., 2019). In addition, through the
implementation of Safewards, there has been significant change in cultural patterns of the
ward which further links to affirmative transformations in their care approaches towards
consumers and thus establishing strong bond and rapport. According to Wand (2015), such
affirmative changes have been originating from realization and improved understanding of
RNs and staffs that they have been positioned to influence majority of facets of the ward
along with the therapeutic procedures as well as interactions.
Conclusion
Hence to conclude, Safewards have the capacity to offer increased level of
motivation, drive as well as support for nursing professionals in order to engage with

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consumers with an improved therapeutical method and from a recovery-oriented standpoint.
Meanwhile, it should be taken into consideration that the emphasis on lessening or
eliminating restrictive practices must not simply be on eradicating obstructions which tend to
disseminate their use. It must further act on removing the supporters of suppression
reduction. Furthermore, at an extensive level, it has shown greater implication to focus on the
importance to seclusion as well as restraint reduction in addition to removal efforts of robust
clinical leadership, adequate rates of nursing professionals as well as resources along with the
consideration of the suitability of the physical unit setting. The Safewards strategy has shown
the capacity of aligning with the policy path in Australia with the agenda of progressing
towards the removal of seclusion and restrictive practices. Safewards can provide the
augmented motivation, impetus as well as support for staff to involve into consumers more
intensely as well as from a recovery-oriented perception. Upcoming research must focus on
the connection of Safewards in addition to recovery-oriented practice on staff well-being and
practices at work. Additional work is essential to comprehend how Safewards interrelates
with other ward activities, related to sensory modulation as well as legislative pressure.
However, additional work is essential to comprehend ways in which Safewards can connect
with other ward undertakings, like sensory modulation as well as governmental coercion.

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