Introduction
This literature review is focusing on discussing the effects of seclusion and restraints on treatment consequences of patients in mental health area. Seclusion and Restraint are used for controlling the behavioral patterns of the mentally ill patients in different surroundings consisting of psychiatric management facilities and hospitals (Kentley, 2009). Over past decade, comprehensible consensus has come out that seclusion and restraints are secure interventions of last alternative and application of those interventions should and can be diminished significantly (Knight, 2011). However, recent studies indicated that it is traumatic for patients experiencing or witnessing restraint and seclusion traumatic; patients can feel high levels of anxiety, fear, and anger once aware that restraint is going to take place, sometimes it could resulting in an exacerbation of patient’s mental status (Stewart et al, 2010). Due to the humanitarian, ethical, and legal issues which could lead to, seclusion and restraints are known as the most controversial management strategies (Holmes, Kennedy & Perron, 2004). Previous studies and researches could not analyze this topic adequately; thus, further researches and studies related to the effects and risk managements of using seclusions and restrains will be discussed in below.
Methodology
A number of different methods were applied in order to gather articles for this review. To narrow the search focus and to avoid vague information relevant nursing journals; mental health related publications; articles on seclusion and restraints effects on treatment outcomes were analyzed for availability and appropriateness of articles. The secondary research was further restricted to 2004 and newer...
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...y of international trends. Social psychiatry and psychiatric epidemiology , 45 (9), 889 - 897.
Stewart, D., Merwe, M. V., Bower, L., Simpson, A., & Jones, J. (2010). A Review of Interventions to Reduce Mechanical Restraint and Seclusion among Adult Psychiatric Inpatients. Informa healthcare, 31 (6), 413-424. doi:10.3109/01612840903484113
Symonds, J., & Huckshorn, K. A. (2004). SECLUSION & RESTRAINT Q&A/Response. Journal of Psychosocial Nursing & Mental Health Services , 42 (12), 8.
U.S. Department of Education. (2010). SECLUSION AND RESTRAINT STATUTES, REGULATIONS, POLICIES,AND GUIDANCE, BY STATE AND TERRITORY.
Sande, R. V., Noorthoorn, E., Wierdsma, A., Hellendoorn. E., Staak, C. V., & Mulder, C. L. (2013). Association between short-term structured risk assessment outcomes and seclusion. International journal of mental health nursing , 22 (6), 475 – 484.
Modern psychiatric hospitals evolved from, and eventually replaced the older lunatic asylums. The treatment of inmates in early lunatic asylums was sometimes brutal and focused on containment and restraint with successive waves of reform, and the introduction of effective evidence-based treatments, modern psychiatric hospitals provide a primary emphasis on treatment, and attempt where possible to help patients control their own lives in the outside world, with the use of a combination of psychiatric drugs and
Yet, solitary confinement is still considered necessary in order to maintain control within the prison and among inmates. Solitary confinement is seen as an effective method in protecting specific prisoners and altering violent/aggressive disobedient behaviors, (Maria A. Luise, Solitary Confinement: Legal and Psychological Considerations, 15 New Eng. J. on Crim. & Civ. Confinement 301, 324 (1989) p. 301). There is some discrepancy among researchers as to the varying effects on inmates who have undergone an extensive solitary confinement stay. Most researchers find that inmates who had no previous form of mental illness suffer far less than those who do, yet most if not all of these individuals still experience some difficulties with concentration and memory, agitation, irritability, and will have issues tolerating external stimuli, (Stuart Grassian, Psychiatric Effects of Solitary Confinement, 22 Wash. U. J. L. & Pol’y 325 (2006) p. 332). Although these detrimental psychiatric repercussions of solitary confinement currently appear, several researches have made suggestions as to how these may be avoided. These requirements being that
Kaba, Fatos, et al. “Solitary Confinement and Risk of Self-Harm Among Jail Inmates.” American Journal of Public Health, American Public Health Association, Mar. 2014, www.ncbi.nlm.nih.gov/pmc/articles/PMC3953781/.
Physical restraint, according to Health Care Financing Administration, can be defined as any handling, physical and mechanical methods applied to a patient with the aim of denying him or her the freedom of movement or access to his or her own body (Di Lorenzo et al., 2011). It may involve use of belts or ties that restrain movement of an individual such as seclusion. Seclusion refers to isolation from others, often done in a room that’s I avoid of any furniture and has a small observable window as the only connection to the outside world (Chandler, 2012). The use of physical restraint in handling patients has been on debate for several years now. In most countries such Italy, it
Seclusion and restraint started out in psychiatric hospitals and have now evolved into many schools. Restraint started out in England in the mid 19th century after having a history of poor conditions. Since Americans did not open up their first state- run mental hospital until 1822, they were unaware of the negative history that happened during the British reformation ("Human Side of Hospitals"). The American physicians thought that the restraints were keeping their patients safe when it was actually mistreatment of their patients. Anything that can be used to restrict the movements of a patient is a form of restraint. Things used as restraints can be leather or velcro wristlets or anklets that are used to hold the patient or attach them to their bed, lock them in their room, or by using sedating chemicals.
Solitary confinement is a mandated arrangement set up by courts or prisons which seek to punish inmates by the use of isolated confinement. Specifically, solitary confinement can be defined as confinement in which inmates that are held in a single cell for up to twenty-three hours a day without any contact with the exception of prison staff (Shalev, 2011). There are several other terms which refer to solitary confinement such as, administrative segregation, supermax facilities (this is due to the fact that supermax facilities only have solitary confinement), the hotbox, the hole, and the security housing unit (SHU). Solitary confinement is a place where most inmates would prefer not to go. There are many reasons for this.
The effects of prolonged isolation for inmates in confinement cells are obsessive-compulsive tendencies, paranoia, anger-management issues, and severe anxiety (Sifferlin, Alexandra). Along with the basic concepts such as food, water, and shelter, there are two other basics that Dr. Terry Kupers states are required for human wellbeing: “social interaction and meaningful activity. By doing things we learn who we are and we learn our worth as a person. The two things solitary confinement does are make people solitary and idle” (Sifferlin, Alexandra). Isolation and confinement remove prisoners’ ability to perform significant tasks and act as a part of society. This dehumanizes the inmates because they are no longer able to understand their role as a human being. One inmate, Jeanne DiMola, spent a year in solitary confinement and expressed her thoughts while in the cell: “I felt sorry I was born … Most of all I felt sorry that there wasn 't a road to kill myself because every day was worse than the last" (Rodhan, Maya). In DiMola’s opinion, a death penalty more than likely would have felt more humane than the isolation she experienced. Another prisoner, Damon Thibodeaux, stated, “Life in solitary is made all the worse because it 's a hopeless existence … It is torture
Throughout life we all live through moments that change who we are; mentally, physically and psychologically. These moments can be, huge and defining or something as small as whether we leave our house or just stay home on a certain day. For some, we find ourselves looking back, and not even realizing the power of the decision we made and how it brought us to who we are now. For others, the decisions we made lead to obvious outcomes. A prime example of this is a criminal. Though, he or she might not have known or thought they would get caught, the acts they voluntarily proceeded in, are illegal and the one and only future they ultimately have is jail or prison. Within the prison system, criminals are faced with these same decisions, but the punishment will have much more detrimental effects than any other decision: solitary confinement. This brings me to my main point. Contrary to many may think, it is not just a myth that solitary confinement can and will have extremely detrimental psychological and social effects on any human being, criminal or not.
Svein Friis, et al. "Mechanical And Pharmacological Restraints In Acute Psychiatric Wards—Why And How Are They Used?." Psychiatry Research 209.1 (2013): 91-97. Academic Search Premier. Web. 22 Oct. 2013.
Thousands of people statewide are in prisons, all for different reasons. However, the amount of mental illness within prisons seems to go unaddressed and ignored throughout the country. This is a serious problem, and the therapy/rehabilitation that prison systems have do not always help those who are mentally ill. Prison involvement itself can contribute to increased suicide (Hills, Holly). One ‘therapy’ that has increased throughout the years has been the use of solitary confinement, which has many negative effects on the inmates. When an inmate has a current mental illness, prior to entering into the prison, and it goes undiagnosed and untreated, the illness can just be worsened and aggravated.
...re have been many studies that have been conducted in the past before the 2000’s, however for this paper those studies were not useful due to the fact that the use of current evidence was the upmost importance. Another limitation to the topic of this paper is that, the studies only include males usually. There has been little information published related to juveniles and women who face administrative segregation or solitary confinement. The hopes of these changes will help reduce the amount of self-harm that is experienced in prisons and jails.
Solitary confinement is occasionally used in most prison systems as a means to maintain prison order: as disciplinary punishment or as an administrative measure for inmates who are considered an escape risk or a risk to themselves or to prison order in general. Some inmates, for example, sex offenders, choose voluntary isolation to avoid harassment from other prisoners. Solitary confinement is popular in America. Solitary confinement is dangerous in its own right. It deprives prisoners of their constitutional rights, and it creates a more dangerous world for all. Supermax prisons remain a major part of the problem, and given that they have shown no ability to hold prisoners without subjecting those prisoners to unconstitutional and unethical
If a person convicted of a crime shows no signs of being mentally ill when entering a prison which enforces the long-term use solitary confinement, by the time they completed their sentence and are released, their mental health will have been severely compromised. Studies have shown that the long-term use of segregation in prisons can cause a wide variety of phycological effects such as anxiety, psychosis, depression, perceptual distortions, and paranoia, often leading to a desire to self-harm or in more severe cases suicide. Not only is it wrong to hold a criminal in solitary confinement for any longer then fifteen days, it is unconstitutional. Although many believe the use of solitary
Some mental health staff defend seclusion as an acceptable way to manage destructive or violent behavior, with others believing it to be counter constructive and not desirable.
In 2001, over 450 million people worldwide suffered from mental illness (World Health Organisation, 2001) and these numbers have increased by a wide margin since then. Using restraints in treatment for those who are mentally ill is a topic that creates a large amount of controversy. Many are concerned with how the use of restraints can affect the person and if they are necessary or if alternative measures could be used. The National Alliance of Mental Illness has indicated their position on restraints, “The use of involuntary mechanical or human restraints or involuntary seclusion is only justified as an emergency safety measure in response to imminent danger to a patient or others.” (The National Alliance of Mental Illness, 2001) There have