Adolescent psychiatric inpatients’ perceptions of treatment and seclusion

Abstract

Objectives: A great deal of attention is being directed at the use of seclusion in adolescent inpatient psychiatric units due to its forceful  nature and negative impact on inpatients and staff. This mixed methods study aimed to explore and compare the level of satisfaction  with the services received and perspectives on seclusion in secluded and non-secluded adolescent inpatients.

Methods: This study  included 188 participants, across three adolescent inpatient psychiatric units in Australia; 17% reported having experienced seclusion. A  mixed methods approach was employed. Participants completed the Consumer Satisfaction Questionnaire–8 and Perceptions of  Treatment and Seclusion Questionnaire shortly before or at discharge. Qualitative data was analysed using thematic analysis.

Results:  Secluded participants were more likely to report issues with broader care experiences on the Consumer Satisfaction Questionnaire–8.  Secluded individuals reported ongoing negative effects from seclusion but were more likely than non-secluded participants to believe  seclusion is necessary. Qualitative analyses showed that both secluded and non-secluded individuals considered seclusion to be  traumatic, many did not agree with its use.

Conclusions: Communication between inpatients and staff regarding seclusion needs to be  improved and there needs to be ongoing support in relation to seclusion during and after discharge. Many adolescent inpatients  acknowledge the necessity of seclusion whilst advocating for reduced seclusion.