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Hazel Watson NHS England Discusses Meeting the new national guidance on seclusion

Hazel Watson Head of Mental Health and Learning Disabilities NHS England Meeting the new national guidance on seclusion at today’s conference. In her presentation Hazel discussed in-depth:

  • ensuring only people detained under the MHA should be considered for seclusion
  • ensuring seclusion is seen as a last resort
  • ensuring any occasion of seclusion is a trigger for an assessment for detention under the MHA undertaken immediately

Hazel Watson full presentation is available for download at the end of this page.

In her presentation Hazel states:

Staff must not use seclusion other than for people detained under the Mental Health Act 1983.

Seclusion is likely to amount to an illegal detention and therefore should be indicator for MHA assessment

The Definition of Seclusion is supervised containment and isolation of a person, away from other users of services, in an area from which the person is prevented from leaving. ‘Its sole aim is the containment of severely disturbed behaviour which is likely to cause harm to others’

The Uses of Seclusion are as a therapeutic intervention to lower stimuli etc, as a ‘nursing’ technique as an alternative to a ‘hands on’ intervention and Management of violence and aggression

Seclusion as a ‘therapeutic intervention’ is used as a calm, quiet, safe, lower stimuli environment the door unlocked, care plan appropriately, consent where possible. Otherwise it will be received as a restrictive intervention, and possibly an illegal detention, using the intervention ‘inappropriately’.

Seclusion as a ‘nursing intervention’ can be used as a de-escalation techniques, in recovery-focussed care. Interventions should be well care-planned and consent should be sought.

In the management of violence and aggression – planned seclusion should only be used to detained, as part of care plan, with consent if appropriate. Unplanned seclusion is MHA assessment triggered.

The need for, or the desirability of, seclusion must be informed by systematic analysis of the evidence, supporting least risk to the patient and staff comparing seclusion with all its alternatives. But the evidence is overwhelming: if you have seclusion, eventually you will use it, and not always for the most extreme situations.

If you do – make sure you practice safely, legally, and humanely

Forthcoming events of interest:

Improving Mental Health Crisis Care
Thursday 30 April 2015, London

Stronger Code: Better Care Implementing the Changes to the Mental Health Act Code of Practice
Tuesday 12 May 2015, London

Masterclass: The Mental Capacity Act and Advance Decisions
Wednesday 13 May 2015, London

Masterclass: The Legal use of Control and Restraint
Thursday 14 May 2015, London

Download: Hazel Watson Presentation

10 March 2015


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