Use of seclusion in an English high security hospital

There is a paucity of information about the use of seclusion in secure settings. The aim of this paper was to establish if any significant trends could be found for its use in a high secure setting. A retrospective descriptive survey of seclusions occurring over a one-year period at Rampton Hospital was utilised. Of the 443 patients within the study sample, 131 (29.6%) were involved in episodes of seclusion. Forty-five per cent of women experienced episodes of seclusion as opposed to 27% of men (p = 0.004). Women were secluded at an average of 11.4 times, mostly following threatening behaviour, whereas males were secluded at an average of 4.3 times (p = 0.03). There were two peak times for initiation of seclusion--10.00 hrs and 17.00 hrs. The survey concluded that women were nearly twice as likely to be secluded as men and averaged three times as many episodes of seclusion. Younger patients were more likely to experience seclusion and spent longer periods of time in seclusion. No statistically significant differences were found between the use of seclusion and ethnicity. The observations related to female patients were particularly interesting and further studies on seclusion are required to inform upon strategies to minimise its use, with specific attention to female patients.