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Tijdschrift voor Psychiatrie 52 (2010) 11, 775 - 783


Reduction in the use of seclusion: some views on the current situation

A. Dols, W. van Tilburg

background In 2001 quality criteria for the use of seclusion and restraint were defined for the purpose of reducing coercive measures imposed during the treatment of mental disorders. The criteria focused mainly on reducing the use of seclusion. There was broad support for the implementation of the policy. We tried to conduct a mid-term evaluation in order to find out to what extent the various policy makers involved were still in favor of the new strategy.
method We interviewed 11 of the parties involved (ranging from politicians and inspectors to professionals and patients) in order to evaluate the process.
results The majority of the interviewees still agreed about the desirability and design of the process. However, there were differences in emphasis regarding the following aspects: quality control, scientific research, patient participation and pressure put on institutions.
conclusion The implementation of the strategy aimed at reducing the number of seclusion is being hindered by the lack of research into the clinical practice of seclusion. If the professionals involved were to initiate such research, it would help to guarantee the quality of patient assessment and ensure the application of the new criteria.

keywords management, restraint, seclusion