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Patterns of seclusion. A prospective study

P H Soloff, S M Turner

    The Journal of Nervous and Mental Disease
    |January 1, 1981
    PubMed
    Summary
    This summary is machine-generated.

    This study on seclusion in acute psychiatric care found its use correlated with patient chronicity, legal status, and race, not mental state. Seclusion primarily contained physical assaults, with duration unrelated to the precipitating event.

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    Area of Science:

    • Psychiatry
    • Clinical Psychology
    • Hospital Administration

    Background:

    • Seclusion is a controversial intervention in acute psychiatric settings.
    • Previous research on seclusion use has yielded varied findings regarding patient characteristics and precipitating factors.

    Purpose of the Study:

    • To prospectively investigate the incidence, frequency, duration, precipitants, and type of seclusion used in acute psychiatric treatment units.
    • To compare characteristics of secluded patients with non-secluded controls.
    • To identify patient demographic, diagnostic, and legal variables associated with seclusion.

    Main Methods:

    • Prospective study design.
    • Data collection on 59 secluded patients (107 episodes) and 159 non-secluded controls.

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  • Analysis of demographic, diagnostic, legal variables, precipitating events, and seclusion duration.
  • Main Results:

    • Chronicity, legal status on admission, and race were significantly correlated with seclusion incidence.
    • Mental status and diagnosis were not significantly related to seclusion incidence or frequency.
    • Seclusion was predominantly used to manage physical assaults on staff.
    • No significant relationship was found between precipitating events and seclusion duration, or with repeated episodes.

    Conclusions:

    • Clinical bias may influence seclusion use in committed, chronic, and Black patients.
    • The independence of seclusion cause and duration raises legal concerns.
    • Findings challenge previous reports on seclusion practices and duration determinants.