Seclusion, Restraint of Mental Health Patients

Introduction

Seclusion refers to confining a consumer at any time during a day or at night singly in a room or an area where an exit and free movements are prevented. There are three different types of restraints: physical, chemical, and emotional. Physical restraints include all forms of restrictions that keep an individual isolated from interacting with the rest of the community using handcuffs, straps, and harnesses, among others. Chemical restraints involve the use of chemicals or chemical processes such as the sedative medication. Emotional seclusion, on an extreme end, involves the use of threats and coercion. A major aspect that differentiates restraints and seclusion from other types of medical treatment is intention. Both seclusion and restraints are adopted to restrict the patient’s movements due to a failure to pay an appropriate mental health attention.

Dangers of Using Seclusion and Restraint

The application of restraint and seclusion has been rampant despite a lack of evidence of any positive outcomes attached to them. The practice is usually connected with a possible abuse of human rights, extended traumas, and a risk of violence. During a lot of years, a small progress has performed concerning handling mental patients. Some health practitioners think that the best way to handle them is using seclusion and restraint, being oblivious of their side effects. This, somewhat brutal, an approach has been a major barrier to the development of other better alternatives. According to National Mental Health Consumer & Carer Forum (NMHCCF), it is a high time for the health personnel working with mental patients to embark on a journey to search for alternatives to replace seclusion and restraint (2012).

Presently, despite being aware of different dangers associated with seclusion and restraint, the approach is the most common in mental hospitals. The reason could be a fact that many mental hospitals are deficient in psychiatric wards. Such deficits make it hard, if not impossible, to employ safer methods of managing aggressive behaviors. These under-resourced and inappropriate situations encourage the use seclusion and restraint. However, mental health professionals should consider both the short-term and long-term well-being of the mental patients they handle. According to New South Wales (NSW), it is going to be possible to look for better alternatives to control the wild behaviors from mental patients without using seclusion and restraint (2012).

When subjected to such brutal treatment practices as seclusion and restraint, mental patients are likely to give up on seeking the medical assistance from hospitals once they are discharged due to the fear of being further stressed. This may further pose more risks to the relatives around an individual or the entire society. The terrifying use of seclusion contributes to the fear of the entire community to seek the medical attention for their relatives suffering from mental problems. Despite a meteoric change in the community outlook of health, particularly the mental one, management has opted to beef up security in psychiatric units for the staff. This is manifested by the presence of security guards patrolling wards, something that creates a confrontational environment in which seclusion and restraint escalate (NMHCCF, 2012).

The worthwhile mental care calls for patience, perseverance, resources, and an ample space to facilitate a delivery of quality services by the health professionals in order to meet the distinct needs of patients. Ironically, it has not come to the attention of health professionals some dangers posed by the current approach. The approaches are not just poor for a patient, but they also set a platform for horrible working places. It is possible that the potential admirers of this profession will be kept off from pursuing it if mental doctors continue to be associated with damaging patients rather than helping them. No one would want to work in such a place. The main issue with the current approaches is the failure to seek more alternatives of care, especially community-based services (Yeager, 2013).

The problem of the ward shortage sometimes forces health professionals to discharge patients quicker than expected in order to create some space for other ceaseless demands. Unless the alternative means of offering care and service are launched, this situation is bound to continue, not as a final resort but as an only available means of maintaining order. The same as it is the matter with other spheres of health, it is not that there is no evidence of other alternatives, but apt means have not been implemented to deploy or fund them.

Although the use of chemical and physical forms of restraint may have reduced, the emotional restraint is equally destructive. When a mental patient is conditioned in such a way that he or she loses the confidence to express his or her views freely to health professionals due to the fear of being victimized, the clinic is using the restraint of almost equal effects like both the physical and chemical restraints. The emotional restraint is threatening and coercive in nature, like when a patient is told unless they remain gentle and isolated. Despite some claims of exclusion of physical and chemical restraint, sometimes the two methods are used especially in the transportation of patients, which still poses great dangers as earlier mention in this document (Stokowski, 2007).

Facts about Seclusion and Restraint

A campaign for a total eradication of involuntary forms of seclusion and restraint should be started in all health centers around the world. This follows the innumerable dangers that the practice poses for consumers. There are many purposes on why this should be done. To start with, involuntary restraint is used in many health centers around the world. Their use is usually associated with neglect and abuse of human rights because patients are forced to do things against their wish. Despite their use, there is no evidence that they have any curative powers. If anything, the methods have highlighted a total failure whenever they are used. This means that they sometimes worsen matters. It is also worth noting that these involuntary methods of restraint are preventable and avoidable as well (Peake, 2013).

Due to the long-term and short-term damages that these approaches have on consumers, they do not serve their intended purpose. They also symbolize a workplace culture of stress and aggression between the powerful health professionals and powerless patients. Finally, they hinder the development of respect and trust among patients, the clinical staff and mental doctors, leading to a distress and fear amongst consumers and weakening of curative relationships. However, sometimes seclusion and restraint may be used when safety of a patient and other people is in jeopardy. In such circumstances, their use should be the last resort and should be carried out in a respectful way by the trained staff (Whittington & Richter, 2006).

The decision on whether to use seclusion and restraint or not is determined by a number of immediate-environment factors. Firstly, the age, gender, legal status, medication, and a diagnosis of a patient are paramount in determining whether to use the involuntary restraint or not. Secondly, the age, experience, and numbers of the staff available dictate whether restraint will be used or not. Thirdly, it is the location of the health unit, whether in rural or urban areas. The mental patient in urban areas is likely to cause more harm than in rural ones. Finally, a ward culture that recommends seclusion and restraint will have its staff used to adopting the method even when it is avoidable. What such a ward ought to know is that involuntary seclusion mostly results to nightmares, insomnia, tension, stress, pain, and distrust of health care services. Victims live under a trauma of torture flashbacks, a poor hospitalization, and a constant depression (NMHCCF, 2010).

Strategies to Curb Seclusion and Restraint

There are different strategies that can be embraced to end involuntary restraint. To start with, a better accountability of all stakeholders in the mental health care units may play a great role in eradicating the use of involuntary restraints. Following a notion that involuntary methods of handling mental patients only causes harm to them, efforts have been made to eliminate them. However, it is unfortunate that less progress has been made in adopting better methods of handling patients. The government should work jointly with other Non-Governmental Organizations to define some measures that can reduce the use of seclusion and restraint. The second strategy is to implement the evidence-based methods to educate health professionals on the effects of using seclusion and restraint. Through a research conducted in many parts around the world, there is no evidence that seclusion and restraint have any therapeutic value. On the contrary, they are associated with the abhorrence experienced by consumers and health professionals (Sharfstein, 2009).

The other strategy is adhering to standards as well as public reporting. A constant use of seclusion and restraint prove the failure by caregivers to adhere to the standards preset by their profession codes. Each mental clinic should ensure that all their clinicians comply with these rules and maintain competency standards throughout their course. Another strategy is to support mental caregivers towards a change of their culture and that of their clinics. Since the use of seclusion and restraint is solely dependent on the culture of clinics and health professionals, it is important to educate and train clinicians on such informed techniques as advanced communication. Consumers should also be educated on their rights in regards to use seclusion and restraint. Clinic audits should be used to ensure that all clinics adhere to these standards (Queensland Government, 2013).

Mental health services are also obliged to ensure that all consumers in inpatient clinic units have holistic evaluations that are sound and in align with the contemporary practices. These psychiatry units should be involved in the improvement of their individual care strategies that aim at reducing the distress and trauma. This should not be the responsibility of a clinic alone but also of other stakeholders including consumers. At last, it is essential to guarantee that there is a constant review of mental health policies. For any regulation to be followed, individuals involved must be aware of the policy and understand it to the uttermost. According to The Royal Australian & New Zealand College of Psychiatrists, auditing arrangements should also be put in place to ensure that stern measures are taken against those ones that do not adhere to them (2010).

Conclusion

The use of seclusion and restraint in psychiatry units has been responsible for innumerable adverse effects to the entire mental health care profession. Consumers are affected by seclusion and restraints, which sometimes result in the unbearable distress and fear of seeking the medical attention in units. The profession is also jeopardized because many potential mental psychiatrists are likely to hate the profession that causes harm rather than being helpful. Since there are better alternatives of handling mental patients, the efforts should be made to affect them through constructive strategies earlier stated.

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