I have been secluded a few times. It is safe to say it just made me furious. It did not make me adjust any behaviours.
On the other hand I've seen the adjusted behaviour of others from this practice..But this is more a pathological reaction to punishment in my view.
In forensic wards it is used for behaviour management and probably as a punitive measure. I have had only limited contact with forensic patients but those experiences were invariably negative as I found I did not or could not empathise with the percieved bizarre behaviours and pathologies. Sadly I can not advocate on their behalf because I lack a sense of identifictaion with said patients.
For ITO patiients seclusion only reinforces the negative perception the patients have of their situation. It is totally disempowering and I don't believe it engenders any kind of future cooperation from these patients.
In youth MH it is a behaviour management tool. As most Child MHUs are part of any city's major hospital they are invariably over crowded and underresourced so often nursing staff take a punitive line when trying to manage negative or aggressrive behaviours in YP. I don't believe there is any valid excuse.
I would advocate for the abolition of seclusion in all hospital settings.
That being said there should never be a crossover betwen general mental health units and forensic units. This happens occasionally ATM because of a lack of infrastructure and resources. Since forensic patients are in fact patients who have commited crimes but are unable to answer charges it is dangerous to general MH patients to share wards. It puts both forensic and general MH patients at risk.
This in no way means I advocate seclusion for forensic patients. I just don't have enough facts. Use of seclusion in prisons has not been proven to be of any worth behaviourly, and there is an increased statistic regarding attempted and completed suicide for prisoners secluded. This has been known for decades.
Short term isolation can have a therapeutic benefit but in my opinion it is the setting and type of isolation which must be considered. Using a jail cell model is stigmatising and I believe inherantly dangerous. 20 years ago seclusion rooms were simply rooms with wide plexi- glass windows and a very simple door with a lock. This allowed patients to still be able to look out and it allowed staff to regualrly monitor the patients progress. It was also only used for short periods ( less than two hours). Though less than ideal it was a humane practice.
Seclusion rooms today have no beds (mattresss on the floor) or furniture, no windows and a steel prison door with a slot for food trays and observation. They not only resemble prison doors but are in fact the same system as those used in criminal detention. These current cells are utilised for days on occasion.
The saddest part? Every general MHU has these cells as part of their infrastructure.
