Perceptions of seclusion: comparing patient and staff reactions

Seclusion, or the use of locked, closely monitored containment, is widely used in psychiatric practice and is legally sanctioned. Involving humanitarian, ethical, and legal issues, seclusion poses dilemmas and raises questions for health-care professionals. Among those defending the practice, some would argue that it is used reluctantly and only as a last resort, whereas others consider it to be a positive therapeutic treatment modality, whether used alone or in conjunction with other treatments. Opponents of seclusion disagree, considering seclusion to be punitive, arbitrary, and geared toward serving the needs of other patients and staff. Although professionals have interpreted seclusion differently with regard to its function, efficacy, and impact, the vast majority of patients view it negatively. Wadeson and Carpenter (1976) found that individuals interviewed 1 year after seclusion still felt bitter about the experience; for many, that experience symbolized their entire psychiatric illness.