Factors influencing decisions of mental health professionals to release service users from seclusion: A qualitative study

摘要

Abstract Aim This study aims to explore and understand factors influencing the decisions of mental health professionals releasing service users from seclusion. Background Seclusion should only be used as a last resort and for the minimum possible duration. Current evidence outlines which service users are more likely to be secluded, why and what influences professionals' decision to seclude. Little is known about factors professionals consider when releasing service users. Design A qualitative study was undertaken to explore factors which influence decision‐making of mental health professionals when terminating episodes of seclusion. Methods Semi‐structured face‐to‐face interviews with 21 professionals were undertaken between May 2017–January 2018. Framework analysis was used to systematically manage, analyse, and identify themes, while maintaining links to primary data and providing a transparent audit trail. Results Six themes were identified where professionals looked for service users to demonstrate cooperation and compliance before they would be released. Decisions were subjective, being influenced by the experience and composition of the review team, the availability of resources plus the emotional tone and physical environment of the ward. Release could be delayed by policy and protocol. Conclusion Professionals should have greater awareness of factors that hinder or facilitate decisions to release service from seclusion and an understanding of how service user views and involves in decisions regarding seclusion should be explored. Impact Senior staff should be available to facilitate release at the earliest opportunity. Staff should ensure that policy and procedures do not prolong the time service users remain secluded.