Perceptions of Psychiatric Patients in Prisons

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 inmates in a correctional facility who also are psychiatric patients, these findings indicate that some inmate concerns over seclusion rooms may be allayed through the provision of information concerning the actual structure and configuration of seclusion rooms in use, as well as assurances that psychiatric care will continue to be provided as needed.

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areas used for psychiatric patients. Rotov (1994) also found that excessive discipline and supervisory toughness can trigger, rather than prevent, violent outbursts by psychiatric patients. This finding is especially relevant for psychiatric patients in corrections facilities where the maintenance of inmate discipline is essential. Nevertheless, there may be ways to maintain discipline without harshness. In psychiatric settings, psychiatric intensive care units (PICUs) have evolved a way to care for patients with acute needs with minimal use of physical restraints or seclusion room (Montgomery & Johnson, 1996). The fundamental purpose of PICUs is to create a safe and controlled environment where intensive nursing care can be provided for psychiatric patients whose behavior warrants unusual vigilance. The underlying presupposition is that intensive nursing care will help the patient move to a more adaptive level of functioning without the loss of dignity that is inevitable with the use of chemical and mechanic restraints, seclusion, or constant observation. The period of care in the PICU is short-term after which the patient is integrated into, or perhaps returned to, a general patient unit (Montgomery & Johnson, 1996).

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