The Importance Of Restraint And Seclusion Of The Mental Health Act ( 1983 )

* Section 1 of the mental health act 1983 was amended in 2007. This section of the act defines a mental disorder as   'any disorder or disability of mind ' it goes on to state that a “learning disability” is define as a state of arrested or incomplete development of the mind which also includes impairment of intelligence and social functioning (MHOL, 2010).

They had gotten to be too extensive, cumbersome and the framework had opened itself up to manhandle. In 1961 the Minister of Health, Enoch Powell was welcome to talk at the AGM of the National Association for Mental Health. In his discourse he reported that it the administration of the day proposed to "the disposal of by a long shot most of the nation's mental clinics." in the meantime, territorial loads up were requested that "guarantee that no more cash than should be expected is spent on redesigning and reconditioning". This declaration had paralyzed the therapeutic callings, as there had been no sign that the legislature was going to travel in this heading; just a modest bunch of trial group care programs existed around the nation. It would

The deinstitutionalization of state mental hospitals has left many individuals untreated and in the community where there come under police scrutiny due to their odd behavior, that is a manifestation of their illness. Majority of mentally ill offenders have not committed a serious crime and are subjected to inappropriate arrest and incarceration (Soderstrom, 2008). This new policy has become quite a concern to the fact that the correctional environment has proven to show no positive results in the mental health of the offender during their time of incarceration or upon their release date and thereafter (Soderstrom, 2008).

Ultimately, involuntary commitment remains a complicated medically and ethically debated topic; one that creates a conflict and clear divide, between individuals who content that involuntary commitment results in vulnerable individuals with psychiatric illnesses being subjective to coercion and civil rights infringement, and those who believe, based on the principle of utility, that involuntary commitment is essential and integral to the safety of the those with psychiatric illnesses, as well as to society as a whole. Both sides offer empirical evidence, as well as moral support for why they believe involuntary commitment is either legally and morally acceptable, or ethically unacceptable, and thereby should be illegal. Regardless, infringing

Horizontal violence is a hidden pattern of individual behavior in controlling other individual that risk health and safety (Hinchberger, 2009). According to Roche, Duffield and Catling-Paull, violence can be describe as emotional abuse, threat, or actual violence in any health care setting. Although the definition varies according to situations and practice settings, there is agreement that workplace violence has a negative impact on the health and wellbeing of nurses and the delivery of quality nursing care (Hinchberger, 2009). Violence mostly occur in any health care setting, However, it mostly occur in emergency department, waiting room, psychiatric ward and geriatric unit on which people involved psychological situations.

A restraint is any physical or chemical measure in the healthcare setting to keep a patient from being free to move (Craven, Hirnle & Jensen, 2013). Nurses are presented with dilemmas in deciding whether to use restraints to protect the patient from falls, harming themselves or others, suppress agitation and to facilitate treatment. Improper usage and misconceptions of restraining can have negative consequences including physical and psychological issues. Physical and psychological disadvantages from restraining could include low blood pressure, decreased circulation, thrombosis, constipation, urinary incontinence, depression, fear and increased confusion (Yeh et al., 2004). Educating nurses may reduce restraint usage by increasing

A practice that has been put in place is the use of call buttons that are installed and easily available for the staff to use when dealing with escalating patients. Within this Veterans Affairs Hospital, the inpatient geriatric unit has at least 2-3 cases of patient-on-patient assault each month. For those that are very aggressive, this is currently being addressed by the use of one-on-one staff and antipsychotic medications. Clinicians are expected to be able to assess whether intervention is needed to protect other patients and staff from patients’ violence, to assess when patients pose a sufficient level of risk, and to assess when patients who have been hospitalized can be safely discharged to the community. However, surveys of practitioners suggest that many receive little formal training in violence risk assessment. (McNeil, et al. 2009) The limitations of formal training in risk assessment for violence suggested by such surveys underscore the need for education in this topic, hence the relevance of this educational training. Nurses on the front lines of care are ill-prepared to deal with this, hence the need for training. (Peek-Asa, et al.

“Unlike most other mental health advocacy organizations in the world, MindFreedom is financially independent from pharmaceutical companies, governments, religions, and mental health systems” (MindFreedom - Fighting Back Against Human Rights Abuses in the Mental Health System 1). This organization is comprised of those who have experienced involuntary psychiatric treatment; as well as their family members and allies. The focus of this group is on human rights violations. Although their arguments and objectives address involuntary commitment, they are not advocating for the violent population. They believe that all people possess the same rights in regards to mental health care, and that those rights include the ability to decline psychiatric treatment. However, their website also states that “There can be no doubt, to reiterate, that people in mental distress and crisis can present challenges for those around them...” (MindFreedom - Fighting Back Against Human Rights Abuses in the Mental Health System 3). The argument of this group is focused heavily on the medication aspect of treatment. However, involuntary commitment can be performed without forcing a patient to take medication. Often, medication is prescribed to help the patient, though it is not a required aspect of treatment (Treatment Settings

Observation is one way in which mental health nurses can protect acutely mentally ill inpatients from harm and is commonly implemented for patients who impose a risk of harming themselves, others and for those who are vulnerable (Bowers et

If a person is detained under a section of the MHA then there needs to be a series of safeguards in place to ensure that any decisions are being made in relation to a persons care are in the best interests of the patient. Mental Capacity Act 2005 When providing a service to others, an individual’s rights need to be taken into consideration at all times. However, when a person is experiencing an episode of mental distress, they may not have the capacity to make some decisions that involve keeping themselves and others safe from harm, therefore requiring others to make decisions on their behalf. The Mental Capacity Act (2005) provides a statutory framework to empower and protect vulnerable people who are unable to make their own decisions (Puri et al,

Patients that we received often wants to either harm themselves or others, and these patients are also considered violent which lead to the frequent use of restraints and seclusion. Using these methods represent a danger to not only staff but also for the patients. Many injuries occur during these confrontations. The need to minimize the use of restraints and seclusion on the unit is necessary for patients and staff safety.

The Joint Commission and Centers for Medicare and Medicaid Service (CMS) have acknowledged, “Physical restraints are considered an infringement of patient rights and a patient safety concern” (Mion, Sandhu, Khan, Ludwick, Claridge, Pile, & ... Winchell, 2010, p. 1279). These organizations have amended and aligned their regulation requirements on the use of restraints which is mainly focused on limiting its use and putting emphasis on staff education and training (Cosper, Morelock & Provine, 2015). The nursing discipline guided by these regulations should aim to improve standards of care and patient outcomes through best nursing practice. “Best practice supports individualized care that permits nursing the person safely and without physical or chemical restraint” (Cotter & Evans, 2010, p.197). The goal of this review is seek evidence to substantiate the implications of such guidelines.

The use of physical restraint is quite common among caregivers in health facilities when dealing with geriatric patients. Yet this topic is one of the most debated issues in healthcare and medicine. The purpose of medical restraints is to prevent patients from harming themselves or those around them. It seems to be a simple solution and panacea for unruly patients who needs to be treated. However, ethical implications surround its usage as the practice of physically restricting people strips them of their autonomy as well as other psychological factors, such as agitation and trauma. Therein lies the dilemma on how to approach such an issue.

Restraints is an intervention used to confine a person to prevent injury to self or others. Different types of restraints include physical, chemical and seclusion. A physical restraint is anything that prevents the patient from being able to freely move. This can include seat belts, wrist restraints, vests, bed rails, etc. A chemical restraint is using a drug for sedation which also restricts movement or freedom. An example of a chemical restraint can be an antipsychotic. These drugs can be used to reduce anxiety, aggression, and violent behavior. Lastly, seclusion is isolating or confining the patient to a room where they cannot leave. This form of restraint is also to protect the patient from harming them self or others. The use of restraints or seclusion can be a useful intervention if all other interventions have failed. Patients should not be harmed with these restraints so it is crucial they are done properly. Patients who are put in restraints

The incidence of aggression and violence in acute mental health settings is internationally recognised as an ongoing and significant issue (Gascon, Martinez-Jarreta, Gonzales-Andrade, Santed, Casalod & Rueda 2009). Although the problem is endemic among mental health professionals, nurses are at a higher risk of experiencing patient or family violence compared to other healthcare providers and auxiliary staff (Schablon, Zeh, Wendeler, Peters, Wohlert, Harling & Nienhaus 2012). Evidence suggests that psychiatric nurses are two times likely to be exposed to threats of assault than medical-surgical nursing. As well, psychiatric nurses are 1.4 times more likely to be physically assaulted and 1.8 times more likely to be emotionally abused compared to nurses working in all other types of units (Hesketh et al. 2003). It is also estimated that between 25% and 80% of nurses employed in acute care hospitals experience various types of aggression (Moylan & Cullinan 2011).