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Locked inpatient units in modern mental health care: values and practice issues
  1. M Cleary1,
  2. G E Hunt1,2,
  3. G Walter2,3,
  4. M Robertson2,4
  1. 1
    Research Unit, Sydney South West Area Mental Health Service, Concord Hospital, Concord, NSW, Australia
  2. 2
    Discipline of Psychological Medicine, University of Sydney, Sydney, NSW Australia
  3. 3
    Child and Adolescent Mental Health Services, Northern Sydney Central Coast Health, Coral Tree Family Service, North Ryde, NSW, Australia
  4. 4
    Centre for Values, Ethics and the Law in Medicine, University of Sydney, Sydney, NSW, Australia
  1. Correspondence to Dr M Cleary, Research Unit, Sydney South West Area Mental Health Service, Concord Hospital, Hospital Road, Concord, NSW 2139, Australia; michelle.cleary{at}


Locked inpatient units are an increasing phenomenon, introduced in response to unforseen abscondences and suicides of patients. This paper identifies some value issues concerning the practice of locked psychiatric inpatient units. Broad strategies, practicalities and ethical matters that must be considered in inpatient mental health services are also explored. The authors draw on the published research and commentary to derive relevant information to provide to patients and staff regarding the aims and rationales of locked units. Further debate is warranted in relation to best practice. Inpatient staff need to be aware of their practice values, be able to access education and supervision and negotiate apparent contradictions. Further patient/clinician focused enquiry is necessary to mitigate the negative and stigmatising effects of locked mental health units.

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  • Competing interests None.

  • Provenance and Peer review Not commissioned; externally peer reviewed.

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