Seclusion Debriefs for Service Users and Team

Dr Stefania Goffredo & Ms Janna Fincke

Seclusions have an adverse effect on service users’ and staff’s wellbeing. Studies suggest that post seclusion debriefs for service users and staff reduce the use of restrictive practice. The main aims of the project are: to gain a better understanding of the effect and experience of seclusion episodes on service user and staff; to mitigate adverse effects; to avoid reoccurrence of seclusion.

In total 33 debriefs were offered by ward psychologists over 11 months. These were conducted in form of semi-structured interviews for service users and focus groups for staff.

Service users had found it difficult discussing their experience of seclusion, but helpful. Being able to express their point of view, and making sense of their experience had been empowering.

Triggers of the escalation of behaviour that had led to seclusion were discussed from the service users’ perspective.

A strong correlation was noted between service users that had been in seclusion and their admission

through Section 136 of the Mental Health Act. Also, a high percentage of service users that had been in seclusion in a male PICU had a diagnosis of or suspected neurodiversity.

From the focus groups it emerged that historical risks play an important role during the decision-making process, as well as difficulties related to the safe implementation of procedures to reduce restrictive practice. 

Themes emerged in seclusion debriefs were regularly discussed in team meetings, in order to review our practice and keep working on prevention of violence and aggression.