Psychiatric mental health nurses frequently are required to care for patients who are acutely psychotic, aggressive, highly destructive, suicidal, or at risk of escape. Traditionally, "management strategies" of such patients have included the use of physical restraints, seclusion rooms, or constant one-to-one observation. These strategies have been criticized on grounds of ethics, economics, and efficacy (Montgomery & Johnson, 1996).
The continued use of seclusion and restraint in psychiatric facilities "in the face of low confidence in such coercive interventions by health care professional may be a sign both of the persistence of traditional practices which have not been closely examined, as well as by the use of these traditional practices to shield the staff of such facilities against fear of mental illness, violence and loss of control" (Goren & Curtis, 1996, p. 7). A research study is proposed that will develop information on the perceptions of psychiatric patients who are inmates in corrections facilities with respect to the use and effectiveness of seclusion rooms.
Background information on the problem and analysis of this information within the context of the use of the seclusion concept in corrections facilities is presented in this section. The background and analysis is presented within the context of perceptions of the seclusion concept, effectiveness of the seclusion concept, and reducing violence without seclusion.
Wise, Mann, Murray, and Lopez (1988) found that psychiatric patients who had never been secluded held more negative feelings about seclusion rooms than did patients who had actually been secluded. They also found that female patients were more critical of the seclusion process than were male patients. The primary concerns of patients with respect to seclusion rooms were that such rooms would be without windows and that when secluded patients would receive only minimal attention. With respect to...