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Seclusion and its context in acute inpatient psychiatric care
  1. Michelle Cleary1,
  2. Glenn E Hunt2,3,
  3. Garry Walter3,4
  1. 1Family & Community Health Research Group, School of Nursing & Midwifery, University of Western Sydney, Sydney, NSW, Australia
  2. 2Research Unit, Sydney South West Area Mental Health Service, Concord Hospital, NSW, Australia
  3. 3Discipline of Psychiatry, University of Sydney, Sydney, NSW, Australia
  4. 4Child and Adolescent Mental Health Services, Northern Sydney Central Coast Health, Sydney, NSW, Australia
  1. Correspondence to Dr Michelle Cleary, Associate Professor, Mental Health Nursing, School of Nursing & Midwifery, University of Western Sydney, Locked Bag 1797, Penrith South DC, NSW 1797, Australia; m.cleary{at}


In acute inpatient mental health services, patients commonly demonstrate extreme behaviours. A number of coercive practices, such as locked doors, enforced medication and seclusion, are used in these settings to control such behaviours. The aim of this report is to explore briefly some of the contemporary debates pertaining to seclusion. A perusal of the literature reveals a clarion call to end the practice of seclusion, without consideration of feasible alternatives. It is hoped that this brief report will encourage further evidence-based discussion and research initiatives on this important ethical topic.

  • Seclusion
  • restraint
  • aggression
  • self-harm
  • acute psychiatric wards
  • concept of mental health

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  • Competing interests None.

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