Lived Experience Forum

[Rick]

http://www.brisbanetimes.com.au/federal-politics/political-news/locking-up-mentally-ill-patients-on-...

[ivana]

Basically,seclusion etc is to make the staff jobs easier,it mostly isn't beneficial for patients. It is perceived as humiliating,controlling,punishing etc.
It often damages patients psychologically and also makes it that staff don't have to learn proactive techniques to manage stress or improve interrelations skills.

A slight decline is good,but the real question is why is it still even legal to do it?
For example,if a child care worker or kindergarten teacher locked an "unruly" child in a seclusion room because they couldn't deal with them,the child was making them feel stressed etc there would be public outrage.
There's always double standards for people with mental illnesses versus other people.

[kristin]

Hi @Rick @ivana 

I'm just catching up on this now. I know from others that this is a deeply distressing practice. I am particularly horrified that the exclusion rate for children is higher than for adults! Talk about traumatising. I agree with you Ivana, it is abusive.

Kind regards,

Kristin

PS What's a forensic service?

[Alessandra1992]

A forensic service is a service where people may be sentenced to live for a specific time instead of jail. Forensic are in Victoria for example..

[Rick]

I have been secluded a few times. It is safe to say it just made me furious. It did not make me adjust any behaviours.

On the other hand I've seen the adjusted behaviour of others from this practice..But this is more a pathological reaction to punishment in my view.

In forensic wards it is used for behaviour management and probably as a punitive measure. I have had only limited contact with forensic patients but those experiences were invariably negative as I found I did not or could not empathise with the percieved bizarre behaviours and pathologies. Sadly I can not advocate on their behalf because I lack a sense of identifictaion with said patients.

For ITO patiients seclusion only reinforces the negative perception the patients have of their situation. It is totally disempowering and I don't believe it engenders any kind of future cooperation from these patients.

In youth MH it is a behaviour management tool. As most Child MHUs are part of any city's major hospital they are invariably over crowded and underresourced so often nursing staff take a punitive line when trying to manage negative or aggressrive behaviours in YP. I don't believe there is any valid excuse.

I would advocate for the abolition of seclusion in all hospital settings.

That being said there should never be a crossover betwen general mental health units and forensic units. This happens occasionally ATM because of a lack of infrastructure and resources. Since forensic patients are in fact patients who have commited crimes but are unable to answer charges it is dangerous to general MH patients to share wards. It puts both forensic and general MH patients at risk.

This in no way means I advocate seclusion for forensic patients. I just don't have enough facts. Use of seclusion in prisons has not been proven to be of any worth behaviourly, and there is an increased statistic regarding attempted and completed suicide for prisoners secluded. This has been known for decades.

Short term isolation can have a therapeutic benefit but in my opinion it is the setting and type of isolation which must be considered. Using a jail cell model is stigmatising and I believe inherantly dangerous. 20 years ago seclusion rooms were simply rooms with wide plexi- glass windows and a very simple door with a lock. This allowed patients to still be able to look out and it allowed staff to regualrly monitor the patients progress. It was also only used for short periods ( less than two hours). Though less than ideal it was a humane practice. 

Seclusion rooms today have no beds (mattresss on the floor) or furniture, no windows and a steel prison door with a slot for food trays and observation. They not only resemble prison doors but are in fact the same system as those used in criminal detention.  These current cells are utilised for days on occasion. 

The saddest part? Every general MHU has these cells as part of their infrastructure.

[ivana]

Hello,

Hope everyone had a peaceful Christmas.
I agree with everything Rick said,particularly the statement "adjusted behaviour of others from this practice..But this is more a pathological reaction to punishment in my view."

Seclusion will always be a breach of human rights and dignity,regardless of whether some "weaker" people "respond or comply to punitive measures".
Seclusion will always be psychologically harmful and unethical as long is it is something forced on someone.
Voluntary,or agreed upon "time out" or "alone time" to gather ones thoughts is ok though.

Are any measures being made to involve people with "lived experience" in implementing changes in psychiatric wards?

[kristin]

Hi @ivana 

Lovely to hear from you. Welcome back! I hope the Xmas break was at least reasonably ok for you (I struggle with it, as I know do many others).

In answer to your question "Are any measures being made to involve people with "lived experience" in implementing changes in psychiatric wards?"

I don't know, as a guess not. I will see whether I can do some ear bending on this here in Vic. Terrible that we have this at all, let alone the worst incidence of it in the country.

Kind regards,

Kristin

[kristin]

Hi @Rick 

It sounds absolutely horrible - really triggering. I'm sorry you had to go through that. I can see why it is an abusive and profoundly unhelpful/traumatic thing to do.

I hear what you are saying about the difference between forensic and other MH patients, and the need to keep tham separated for everyone's wellbeing.

I know that it would feel like torture to me if I were treated in such a fashion. It is the possible loss of control that is one of my biggest fears, and reason why I hate hospitals and have never had a psych admission no matter how sick I am. Being sexually abused (at the age of nine) in one has been a very effective preventative - even during all the intervening years when I had no comprehension of what had happened to me.

Hope for positive change endures...

Kindest regards,

Kristin