Seclusion in mental health nursing.

I will explore the advantages and disadvantages of seclusion and give a clear definition of seclusion in this blog.  Seclusion is defined by the oxford dictionary as  ‘The state of being private and away from other people’. The royal college of psychiatrists define this as“the supervised confinement of a patient in a room, which may be locked. Its sole aim is to contain severely disturbed behaviour which is likely to cause harm to others.”

Seclusion is a controversial and emotive topic and while some may argue that it is draconian and infringes on ones rights,  others assert that it is often used as a last resort measure to manage the risk posed to others.  The mental health act 1983  allows clinicians to detain and treat an individual however does not cover issues regarding seclusion. Seclusion is only covered in the mental health act code of practice 1983 however, this only provides guidance and as such is not a legally binding document.  This issue has provoked considerable debates in domestic courts. Seclusion should not be used as a punishment, threat, as part of a treatment plan, because of shortage of staff or where there is a risk of self harm or suicide.

Conflcit-  The conflict between seclusion and civil liberties is one that is undeniable. One issue is the contrast between seclusion and Article 3 and 8 of the european convention on human rights. Article 3 provides that: “No one shall be subjected to torture or inhuman and degrading treatment or punishment.” Article 3 protect detained patient and states that any intervention that cannot be justified under therapeutic necessity will breach this article. The patient must show that the interventions in question were not a therapeutic necessity. Therefore, in the absence of evidence that seclusion was unnecessary, it is presumed legal.                                                                                                                                                                             Seclusion potentially interferes with Article 8 (1) which provides that:“Everyone has the right to respect for his private and family life, his home and his correspondence.”
This is however, subject to derogation under specified conditions.   This being the case it was decided by in munjazi in a landmark decision that, seclusion is justifiable if there is a threat to public safety. If used properly, seclusion is not a disproportionate measure because it matches necessity that give rise to its use.

The courts recognise the importance of seclusion in psychiatry. Along with this recognition comes a huge responsibility for psychiatric professionals to ensure its use is judicious.


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