Factors influencing decisions of mental health professionals to release service users from seclusion: A qualitative study

Aim

This study aims to explore and understand factors influencing the decisions of mental health professionals releasing service users from seclusion.

Background

Seclusion should only be used a last resort and for the minimum possible duration. Current evidence outlines which service users are more likely to be secluded, why and what influences professionals’ decision to seclude. Little is known about factors professionals consider when releasing service users.

Design

A qualitative study was undertaken to explore factors which influence decision‐making of mental health professionals when terminating episodes of seclusion.

Methods

Semi‐structured face‐to‐face interviews with twenty‐one professionals were undertaken between May 2017 ‐ January 2018. Framework analysis was used to systematically manage, analyse and identify themes, whilst maintain links to primary data and provide a transparent audit trail.

Results

Six themes were identified where professionals looked for service users to demonstrate co‐operation and compliance before they would be released. Decisions were subjective, being influenced by the experience and composition of the review team, the availability of resources plus the emotional tone and physical environment of the ward. Release could be delayed by policy and protocol.

Conclusion

Professionals should have greater awareness of factors that hinder or facilitate decisions to release service from seclusion and an understanding of how service user views and involvement in decisions regarding seclusion should be explored.

Impact

Senior staff should be available to facilitate release at the earliest opportunity. Staff should ensure that policy and procedures do not prolong the time service users remain secluded.