[Seclusion in emergency psychiatry]

Area of Science:

• Psychiatry
• Mental Health Care
• Health Policy

Context:

• Seclusion, also known as «shielding» or «open-area seclusion», is a controversial intervention in Norwegian inpatient psychiatric wards.
• Its use is often a continuation of milieu therapy, with decisions made by psychiatrists or psychologists under the Mental Health Care Act.

Purpose:

• To review the available literature on the justification, practical application, and effects of the Norwegian seclusion tradition.
• To address the uncertainty regarding the content and academic legitimacy of this model.

Summary:

• The study reviewed literature from 1930-2013, finding seclusion is linked to psychiatric institution development but has a poor knowledge base.
• Clinical studies are mostly outdated, and there's a lack of efficacy studies, indicating limited knowledge on seclusion's treatment benefits.
• A significant gap exists between the widespread clinical use of seclusion and its supporting evidence base.

Impact:

• Highlights a major discrepancy between the clinical ubiquity of seclusion and its limited evidence base.
• Underscores the urgent need for more research into various seclusion methods to evaluate their effectiveness in current psychiatric practice.