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Reduction in the use of seclusion in a high secure hospital: A retrospective analysis

Published online by Cambridge University Press:  18 November 2009

Inti Qurashi*
Affiliation:
Consultant Forensic Psychiatrist, Ashworth Hospital, Liverpool, UK
Des Johnson
Affiliation:
Deputy Service Manager, Ashworth Hospital, Liverpool, UK
Jenny Shaw
Affiliation:
Consultant Forensic Psychiatrist, Guild Lodge Regional Secure Unit, Preston, UK
Ben Johnson
Affiliation:
Consultant Psychiatrist, Ashworth Hospital, Liverpool, UK
*
Correspondence to: Dr Inti Qurashi, Ashworth Hospital, Parkbourn, Maghull, Liverpool, United Kingdom, L31 1HW. E-mail: Inti.Qurashi@merseycare.nhs.uk
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Abstract

Specific concerns have been raised about seclusion use within mental health services. However, it has been reported that one of the potential consequences of reduced seclusion use is an increase in assaults on either clinical staff or patients. In a high secure hospital a number of measures were implemented as part of a clinical governance programme. These measures will be described. Data on all episodes of seclusion and adverse incidents over a five year period was analysed. The results demonstrate a progressive and sustained reduction in seclusion use with over a sixty percent reduction in the number of seclusion episodes. We found no increase in adverse incidents in conjunction with the reduction in seclusion use. The results of this analysis demonstrate that reductions in seclusion use are achievable, without an increase in assaults on clinical staff or patients, when it is identified as both a managerial and clinical priority, supplemented by robust performance monitoring and effective clinical governance arrangements.

Type
Original Paper
Copyright
Copyright © NAPICU 2010

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