title: Seclusion experienced by mental health professionals.
abstract: Seclusion in psychiatric inpatient care means confining service users in a locked room. Service users and staff seem to have different opinions on the usefulness of seclusion. This is possibly the first time when two mental health nurses went voluntarily into seclusion and reported their experiences. The nurses felt that the seclusion room was inhumane and proposed improvements to seclusion in general and to the seclusion facilities in particular. Seclusion in psychiatric hospital care refers to isolating a service user from other service users and staff, most often in a locked and unfurnished room. Service users' experiences of seclusion are mostly negative, and although some have seen a rationale for its use, mental health nurses should be encouraged to evaluate current seclusion practices from the service user's perspective. In this small-scale experiment, two mental health nurses were voluntarily secluded for 24 h. The aim was to explore the experience of being secluded, to understand and evaluate the impact of seclusion in greater detail, and to encourage discussion on one of the controversies in mental health nursing. To the best of our knowledge, this is the first attempt to evaluate the impact of seclusion based on mental health nurses' firsthand experiences. The nurses received usual seclusion treatment and described their experiences of this every 6 h. Based on the nurses' experiences, seclusion, even in voluntary, safe and planned circumstances, may increase anxiety and frustration. Seclusion was viewed negatively and the physical environment was considered inhumane. The nurses offered some practical suggestions for updating seclusion practices and re-designing seclusion facilities. Mental health nurses, who frequently decide on and invariably implement seclusion, are key to improving seclusion practices.
authors.affiliation: Department of Nursing Science, University of Turku, Turku, Finland.|Social and Healthcare Department, City of Vantaa, Vantaa, Finland.|Nordic Network for Reducing Coercion in Care, National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: L
authors.initials: L
authors.lastname: Kuosmanen
authors.affiliation: Department of Nursing Science, University of Turku, Turku, Finland.|Department of Psychiatry, Hospital District of Southwest Finland, Turku, Finland.
authors.forename: P
authors.initials: P
authors.lastname: Makkonen
authors.affiliation: Department of Psychiatry, Hospital District of Southwest Finland, Turku, Finland.
authors.forename: H
authors.initials: H
authors.lastname: Lehtila
authors.affiliation: Mental Health Service User Association, ITU, Turku, Finland.
authors.forename: H
authors.initials: H
authors.lastname: Salminen
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D005387:Finland; D006801:Humans; D009741:Nursing Staff, Hospital / Q000523:psychology*; D010356:Patient Isolation / Q000523:psychology*; D011568:Psychiatric Nursing / Q000592:standards*
keywords: narratives; patient rights; professional development; seclusion and restraint