Patients’ Experiences of Seclusion during Admission in Psychiatric Settings in KwaZulu-Natal: A Qualitative Study

  • Benoite Umubyeyi Department of Mental Health Nursing, School of Nursing and Midwifery, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
  • Gilbert Banamwana Department of Mental Health Nursing, School of Nursing and Midwifery, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
  • Pacifique Mukangabire Department of Mental Health Nursing, School of Nursing and Midwifery, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
  • Innocent Kagabo Department of Mental Health Nursing, School of Nursing and Midwifery, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
  • Jeanne D’Arc Jeanne D’Arc London School of Hygiene & Tropical Medicine, UK
  • Emmanuel Bagaragaza Pole Recherche et Enseignement Universitaire SPES- Maison Médicale Jeanne Garnier, Paris, France
Keywords: Seclusion, disruptive behavior, aggression, psychiatric setting

Abstract

Background

In South Africa, seclusion is one of the practices used in the management of disruptive behaviors in psychiatric settings. Despite its continued use, seclusion is always subject to controversial debates, and patients who undergo it express a range of negative experiences.

Objective

To explore the experiences of patients regarding seclusion during their admission in a psychiatric hospital.
Methods

A qualitative descriptive design was used. In-depth interviews were conducted with ten patients attending a community psychiatric clinic in KwaZulu-Natal. Interviews were analyzed using content analysis.

Results

Two themes emerged from the findings: controversial views of seclusion and negative experiences of seclusion. Seclusion was considered more as a punishment measure which was often used abusively, than a therapeutic intervention. Participants expressed loneliness, humiliation, and powerlessness following their seclusion experience. Limited patient-staff interaction and communication worsened patients’ negativity towards seclusion.
Conclusion

Findings from this study underscore the need to review practices, policies and procedures regarding the use of seclusion. Seclusion should be only used when the need is absolute and as the last treatment option. Open communication between the care providers and the patients should be emphasized during the time of seclusion.

Rwanda J Med Health Sci 2020;3(3):342-361

Published
2020-12-30
Section
Articles

Journal Identifiers


eISSN: 2616-9827
print ISSN: 2616-9819