In 1997, the Australian mental health team developed the principles of mental health services for their promotion and guiding in the country. In the guidelines and policies accepted, they paid much attention to reducing seclusion and restrictions to patients that had to be minimal. This newly adopted politics was one of the measures of high priority to nurses and other staff members (Muralidharan, 2006).
Restraint is an outside control method used to limit, reduce or even prevent movement of a person, in particular a patient, from one place to another. It is mainly done to stop the patient from inflicting harm to themselves or to others. Generally, there are two types of restraint. The first one is called physical restraint and involves application of external force to prevent a patient from inducing pain or injury to themselves or other people, as well as to avoid harmful situations. The second one is a mechanical restraint that refers to the act of persons’ containment with the help of mechanical tools. It may include the use of such appliances like asbelts, straps, and sheets for limiting free movement of a patient’s body and making him or her become harmless (Muir-Cochrane, Holmes, & Walton, 2002).
Seclusion refers to the act of putting patients away from other people in an isolated place, where chances of exit are minimal or non-existent. Seclusion should be performed within the minimum time possible, as any delay may lead to disastrous repercussions on a patient’s health. The use of restraint and seclusion is one of the most challenging ideas and practices that have been applied in mental hospitals in various countries globally (Muralidharan, 2006). However, the practice has generated many debates in various legal and professional forums about how safe it is for people. Although seclusion and restraint could be observed in many countries, the process of evaluating their application is hindered by the lack of research and consistent clinical guidelines and policies.
By and large, these methods should only be utilised as the last resort to emergency situations. From the three case studies reviewed, it is obvious that restraint and seclusion methods are not the best way to treat patients. The first patient said such treatment only escalated his emotions, thus causing him a great pain. The second patient also testified that these methods only make him have flashbacks about his father, thus causing him more harm than good. Finally, the third patient asserted that these methods make her feel angrier and more anxious. Therefore, from the three reports above, it is clear that neither restraint nor seclusion could be viewed as the best method to use on patients (Muir-Cochrane et al., 2002).
In the first place, the following recommendations can help patients develop good practices without involving restraint and seclusion. First and foremost, it is important that safety measures be taken to ensure that the methods under consideration are reduced at all levels of mental patients’ problems. This would involve elimination of restraint and seclusion completely. In addition, nurses should be trained to provide safe guidance to patients, including safe working environments. Nevertheless, these methods should not be used unless on unavoidable circumstances only (Muralidharan, 2006).
With the help of educated nurses, such instances can be avoided in all mental health centres globally. It is also important that the proposal for improving health care environments be tailor-made to allow safe and secure services where patients are prevented from inflicting injuries to themselves or to others. Besides, there is a need for cultural change on the part of health staff and nurses, who should look for other proper ways of treating mental patients. To make more positive changes, it is recommended that nurses be trained on change in attitude and beliefs, in order to be involved in other methods of treatment (Muralidharan, 2006).
Taking into consideration that seclusion is dangerous, it can be used in cases of emergencies where other methods are not applicable. Speaking about other methods, one may mention treating patients with much respect and equality to enable them to feel valuable and significant people in the society. Needless to say, this will promote their dignity and safety measures. In addition, nurses and other staff members should be involved in the implementation of these new methods and be trained on the best methods to use. Proper skills as well as clean and safe environment can be a base for avoidance of seclusion and restraint (Muir-Cochrane et al., 2002).
It is to be remarked that nurses and other staff working in mental health centres should be provided with proper knowledge and skills of dealing with practices and policies of seclusion and restraint. It is important to get leaders and other people tasked with the management of mental health centres in order to reduce the number of seclusion cases. Consistent evaluation of the mental health services and accountability of the people involved should be enhanced in all conditions and circumstances of mental problems. One should keep in mind that the staff is to develop the best clinical practices and standards in the sector. In line with this, clinical education can be developed to arrange services offered by health centres. Proper training strategies and support should be provided where necessary. Moreover, the use of sensory interventions, therapeutic environment and non-violent culture in addition to the use of therapeutic methods play a crucial role (Muir-Cochrane et al., 2002). Distress, seclusion and restraint management can build proper guidance, which may involve provision of proper and timely communication, including demonstration of good support and application of the best practices through research and publication (Muralidharan, 2006).
It should be mentioned that mental health problems can lead to mental incapacity or behaviour disorder. The success of a human’s thinking process may be measured by assessing how well a person is able to create a conducive life environment as well as optimally link up life activities and efforts. Thus, the patient may be psychologically at ease. Generally, mental health is defined as an expression of emotions and feelings including flashbacks and pain. However, if these expressions are negative, they may lead to such conditions as depression and anxiety disorders.
Global mental health care sector is an area of study that deals with research and practice that places priority on improving health services to patients worldwide. Seclusion and restraint should be avoided in order to improve universal mental health care sector because the world population is affected in one way or another by mental diseases or illnesses. This later leads to low self-esteem in patients suffering from mental illnesses. Consequently, patients will fail to form proper relationships and cannot carry out their everyday activities effectively. In fact, when a person suffers emotionally, he or she may look sick. Indeed, mental health condition may be a reason why people engage in immoral activities such as substance abuse and drug addiction, causing low productivity at work, thus affecting the economy of the entire country.
One should consider that every person should seek ways to maintain good health, which will have the benefit of prolonging life free from illnesses. According to Richards and Bergin (2000), “good mental health can enhance one’s life, while poor mental health can prevent someone from living an enriching life” (p. 12). In addition, the authors can identify some connection between emotional abilities of a person and his or her behaviours like stress management and physical activities. Moreover, it is true that any limitations in emotional expression may not only lead to poor health, but also to vices that are unacceptable in the society. These can cause behaviours that are directly related to the state of mental health as well as individual’s dangerous activities causing suppression of emotions. The authors outline that “some of these acts include drug and alcohol abuse, physical fights or vandalism” (Richard & Bergin, 2000, p. 14).
From the above discussion, it is evident that the following can be done to both patients and nurses in order to enhance their emotional well-being and prevent injuries to both, and to minimise painful feelings of the patients. Patients, who are healthy in the emotional, physical and mental sense, can have the ability to maintain a positive outlook and remain focused, flexible and creative (Patel, 2020).
It clearly appears that a person needs to eliminate the cause of the issue with a goal to improve his or her mental health in general. This may include “avoidance of risk factors; promotion aims to enhance an individual’s ability to achieve a positive sense of self-esteem, mastery, well-being, and social inclusion” (Barlow & Durand, 2011, p. 44). One thing that is crucial in achieving it is ensuring that the social environment of the patient is conducive and people around have can offer social support. Physical activities, especially those relating to aerobics bear significance for improving a person’s mental health, for example, meditation. According to the study on well-being, proper mind-set is considered to be a good and healthy condition that can be promoted by changing one’s attitude and improving one’s self-esteem (Richard & Bergin, 2000).
To recover faster from a mental health problem, the following therapies can be applied for better results: expressive therapies with the help of music and dance, reciting of poems and other forms of literature (Storrie, 2010).
Secondly, alternative therapy and traditional medicine, prayer and hypnotherapy may be utilised (Storrie, 2010). In addition to that, one could see a certain effect in meditation that predetermines “increased awareness of mental processes, which can influence emotional behaviour and mental health” (Patel, 2020, p. 1976). This may cover showing compassion to others for easy recognition of their emotions in order to resolve their problems better.
Finally, there are other therapies like group therapy, in particular, activity groups for psychodynamics, pastoral counselling, which provides religious advice from the leaders, and psychotherapy, which can help in developing the science-based medicine, dealing with mental issues like cognitive and dialectical behavioural therapy (Storrie, 2010).
References
Barlow, D.H., & Durand, V. (2011). Abnormal psychology: An integrative approach. New York, NY: Cengage Learning.
Muir-Cochrane, E.C., Holmes, C., & Walton, J. (2002). Legal and ethical aspects of seclusion: An Australian perspective. Journal of Psychiatric and Mental Health Nursing, 8(6): 501-506.
Muralidharan, S.M. (2006). Containment strategies for people with serious mental illness. Cochrane Database Syst Rev., 3: CD002084.
Patel, V.P. (2010). Global mental health: A new global health field comes of age. JAMA, 303(19): 1976-1977.
Richards, P.S., & Bergin, A.E. (2000). Handbook of Psychotherapy and Religious Diversity. Washington DC: American Psychological Association.
Storrie, K. (2010). A Systematic review: A student with mental health problems. International Journal Nursing Practice, 16(1): 1-6.