A retrospective study of the effect of the implementation of an unlocked seclusion policy was conducted on three child psychiatric inpatient units in a state hospital in Pennsylvania. Unlocked seclusion was associated with 1) increased use of tranquilizing medications administered as needed on all three units, 2) increased clustering of medications, administered as needed, in the units that used seclusion most, 3) diverse changes in the three units regarding frequency and clustering of unlocked seclusion, and 4) increased correlations between medications administered as needed and seclusion, particularly in the more behaviorally disturbed children. These findings suggest that locked seclusion may be a necessary therapeutic intervention, particularly with severely disturbed children with serious conduct and impulsive disorders.
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http://dx.doi.org/10.1176/ajp.147.10.1283 | DOI Listing |
Int J Ment Health Syst
December 2020
College of Medicine and Public Health, Flinders University, PO Box 2100, Adelaide, South Australia, 5001, Australia.
Background: Pasung is the term used in Indonesia and a number of other countries for seclusion and restraint of people with mental illness in the community, usually at home by their family. While pasung has been banned because it is contrary to human rights, its practice continues to exist within the community, particularly where community mental health services are limited, and in the absence of adequate social support, and pervasive negatives beliefs about mental illness. It is essential to understand the reasons for the ongoing use of pasung and to examine potential solutions.
View Article and Find Full Text PDFBJPsych Bull
April 2017
Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.
The acute psychiatric in-patient service in Christchurch, New Zealand, recently changed from two locked and two unlocked wards to four open wards. This provided the opportunity to evaluate whether shifting to an unlocked environment was associated with higher rates of adverse events, including unauthorised absences, violent incidents and seclusion. We compared long-term adverse event data before and after ward configuration change.
View Article and Find Full Text PDFBMJ
April 2000
H M Inspectorate of Prisons, Home Office, London SW1H 9AT.
Objective: To investigate the facilities for inpatient care of mentally disordered people in prison.
Design: Semistructured inspections conducted by doctor and nurse. Expected standards were based on healthcare quality standards published by the Prison Service or the NHS.
Am J Psychiatry
October 1990
Mayview State Hospital, Bridgeville, Pa.
A retrospective study of the effect of the implementation of an unlocked seclusion policy was conducted on three child psychiatric inpatient units in a state hospital in Pennsylvania. Unlocked seclusion was associated with 1) increased use of tranquilizing medications administered as needed on all three units, 2) increased clustering of medications, administered as needed, in the units that used seclusion most, 3) diverse changes in the three units regarding frequency and clustering of unlocked seclusion, and 4) increased correlations between medications administered as needed and seclusion, particularly in the more behaviorally disturbed children. These findings suggest that locked seclusion may be a necessary therapeutic intervention, particularly with severely disturbed children with serious conduct and impulsive disorders.
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