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Seclusion Room: A Case Study

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Seclusion is defined by the Mental Health Commission (2009 p.19) as ‘the placing or leaving of a person in any room alone, at any time, day or night, with the exit door locked or fastened or held in such a way as to prevent the person from leaving.’ Newton-Howes (2013) further describes the seclusion room as a locked room, which is sparsely furnished with little detached or hazardous objects in a reduced stimulus environment to promote the regaining of self-control following a period of acute mental distress. The Mental Health Commission recorded 1,403 episodes of seclusion in 2012. According to Gutheil (1978 as cited in Muir-Cochrane 1995) the purpose of seclusion can be identified through three dimensions: the management of unwell persons, …show more content…

as cited in Roberts 2004). Autonomy is described as an individual’s right to self-governance around their care and the requirement of healthcare professionals to respect these decisions (Kirby et al. 2004). However the patient and healthcare professional can sometimes have conflicting views regarding a person’s capacity for autonomy particularly persons who are acutely unwell. Despite JB expressing his dislike of being placed in seclusion, nursing and medical staff agreed JB’s capacity to make an informed autonomous decision was impaired due to his current mental distress. Roberts (2004) states that the paternalism in mental health is rationalized through the concept that mental illness can inhibit a persons’ competency and ability to act autonomously in the governance of their care and therefore principles of beneficence and non-maleficence must be introduced to ensure that person receives adequate care. Prinsen & van Delden (2009) also argue that coercive measures such as seclusion can be necessary in reclaiming personal autonomy and control. However this paternalistic viewpoint of overruling a patient’s autonomy is arguable especially if a person is deemed incompetent due to their mental illness. Szasz believed mental illness was mythical and the introduction of a diagnosis was merely to label social deviancy from social norms. Therefore Szasz challenged the paternalistic practices of coercive and powerful …show more content…

One form of consequentialism is the theory of utilitarianism, which presents an ethical argument from the perspective of the benefit of the greater good with rights and obligations becoming secondary to public welfare (Williams 2009). Bentham presented the idea that the action can be concluded as right if the greatest positive outcomes occurs with Mill modifyinh this theory further to explain the ultimate goal of utility as the greatest amount of satisfaction for the general population (Muir-Cochrane 1995). Therefore the override of a patient’s autonomy for the greater good can be justified by the utilitarianism theory and in the case of JB justifies the reasoning of placing an aggressive and violent JB in seclusion to ensure safety of the patients and staff, to maintain a harmonious and secure environment and to maintain the therapeutic milieu on the ward. However utilitarianism principles can be criticized as it is not possible to measure the satisfactory amount of happiness or unhappiness described by this theory, therefore leading to differing opinions defining ‘best’

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A piece of legislation was created in 2005, with the purpose to allow clinicians to make decisions for the patient, when it is deemed that they haven’t got the ability to think clearly or understand information that is being presented to them, whether that is permanently or temporarily. Whilst this is the case, different levels of capacity are required for different decisions, so a patient cannot be “deprived of their liberty” (SCAS, 2010, 5) and all decision made in the best interest of the patient must be the “least restrictive alternative” (SCAS, 2010, 7.1). This means that these decisions cannot cause the patient to feel uncomfortable, embarrassed, or be detrimental to their health. Until proven otherwise, everyone is assumed to have capacity to make a decision. There are a variety of reasons that affect a patient’s capacity; neurological conditions (eg. dementia etc), head/brain trauma (eg. concussion etc) learning disabilities, effects of hypoxia, the effects of alcohol or substance use, amongst others (SCAS, 2010, 7.1).

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He went on to explain that the people in those institutions are very limited to the things they are able to do and the choices that they can make. Simple choices such as what to eat, what to wear, and what to do in your freetime are made for the mentally ill by the workers. The patients are forced to take medication against their will and are also limited to everyday things such as being outside. There is so much dehumanization that occurs that the mental hospital doesn't feel like a place where the patients are receiving help. Instead, the patients themselves refer to being at the mental hospital as “doing time” as they would in

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Staveill started to develop destructive habits in solitary confinement. I believe Mead would also add to Goffman and the idea of total institutions while being in solitary confinement is that it disrupts the process of “I” and “me”. Mead argues that we gain our sense of self through our interaction with others. This is very important to look at because in Solitary confinement people are isolated and what we can assume based on mead's theory of how we come to know who we are is that solitary confinement is doing more harm to the individual rather than helping them because they lose their sense of self. In the essay, it is evident that this occurs.

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It would take countless months or even years after solitary to fully attain my physical health before I was out in confinement. Moreover, the effect that solitary confinement would have on my mental health would be much greater. Being locked in a room for a number of years all by myself with no chance of gaining human contact would

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Healthcare professionals must work on the assumption that every patient has the capacity to make decisions about their care, and to decide whether to agree to, or refuse, an examination or treatment. However, in the case that patients are deemed to be lacking capacity the Mental Capacity Act (2005), The Adults with Incapacity (Scotland) Act (2000) legislations must be followed (General Medical Council, 2008). Gaining consent before providing care or treatment to any patient is very important because patient requires

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According to Singer (2011), autonomy refers to a person to live their lives according to their own decisions. Seedhouse (2009) has a different perspective, as he considers autonomy as a quality; the better quality the autonomy, the more the person is able to do. When it comes to healthcare and maintaining health status, there are two types of autonomy. These are creating autonomy and respecting autonomy. Creating autonomy refers to any work aimed at enabling an individual and improving their capacity to achieve their goals and to do things.

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• These classifications do not account for people who have ‘atypical’ symptoms or those that do not clearly follow the ‘script. • Critics claim that categorical systems reduce humans to one-dimensional sources of data rather than encouraging practitioners to treat the whole person. • Critics also see these systems as tools for social control – giving mental health professionals control over people’s lives. 3. Explain two alternative frameworks for understanding mental distress.

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The four core ethical principles that are called into question in the movie “Miss Evers’ Boys” are autonomy, beneficence, nonmaleficence, and justice. Autonomy refers to the right of the patient to function independently and the ability to self-direct. This means that patients are entitled to decide what will happen to them, and if deemed competent, they have the right to either consent to or refuse treatment. All nurses and healthcare personal would be required to respect the patient’s wishes, even if they do not agree with them. Beneficence is the core principle that refers to the act of ‘doing good’ and advocating for the patient.

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Utilitarianisms would answer the question in the affirmative and change the track so only one person has to suffer. However, we have to question if the Utilitarianism is applicable to such ethical questions (Smart & Williams, 1973). This essay will outline several strength and weaknesses of the Utilitarianism devised by Jeremy Bentham. Firstly, the Utilitarianism will be outlined, secondly some strength and weaknesses are explained by employing examples, and thirdly several solution approaches for dilemmas Bentham’s Utilitarianism is facing will be sketched.

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