Observation Seclusion and Restraint

Use of more intensive nursing categories on an open ward can greatly reduce the need for seclusion or restraint of patients, which should be undertaken only after less restrictive alternatives have failed or when they are considered to have a low probability of success [11]. This is particularly important in first admission patients for obvious reasons. Clinicians must review secluded or restrained patients as often as needed to monitor any changes in physical or mental status and to comply with mental health legislation. Release from seclusion or restraint can be graded, as the risk of harm to self or others diminishes.

If seclusion is to be therapeutic, it should include prior orientation to the reality of being secluded, then reduction of sensory input, then reintegration back into the general ward environment [76]. Like other interventions, it should be patient-centred, with patients encouraged to exercise choice and enhance necessary coping skills.

In the early psychosis inpatient unit, an intensive care area should be used flexibly, and primarily to provide brief periods of ''time-out'' for patients. The period in the intensive care area may be as little as an hour. It provides a low-stimulation environment with limited contact with other patients, allowing irritability and aggression to abate in a safe environment.

Seclusion should be used rarely. It can be used if it is necessary to protect the person or others from an immediate or imminent risk to health or safety, or to prevent the person from absconding. The use of seclusion, and requirements for monitoring and reporting on seclusion, are governed by mental health legislation.

BiPolar Explained

BiPolar Explained

Bipolar is a condition that wreaks havoc on those that it affects. If you suffer from Bipolar, chances are that your family suffers right with you. No matter if you are that family member trying to learn to cope or you are the person that has been diagnosed, there is hope out there.

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