Qualitative systematic literature review: the experience of being in seclusion for adults with mental health difficulties

Publication Date13 March 2017
Date13 March 2017
DOIhttps://doi.org/10.1108/MHRJ-04-2016-0007
Pages1-15
AuthorAmy Mellow,Anna Tickle,Michael Rennoldson
SubjectHealth & social care,Mental health
Qualitative systematic literature review:
the experience of being in seclusion for
adults with mental health difficulties
Amy Mellow, Anna Tickle and Michael Rennoldson
Abstract
Purpose The purpose of this paper is to conduct a systematic search of the peer-reviewed qualitative
literature investigating the lived experience of seclusion for adults with mental health difficulties, to appraise
the quality of the existing literature and synthesise findings. Background: seclusion is a controversial
intervention for the short-term management of unsafe behaviours in inpatient mental health services. There
has been some sporadic interest in service usersexperiences of this.
Design/methodology/approach Systematic literature review and meta-synthesis: data sources
databases MEDLINE, EMBASE, CINAHL and PSYCINFO were searched in July 2015; review methods the
Joanna Briggs Institutes Qualitative Assessment and Review Instrument tools for critical appraisal and data
extraction were used to review papers and synthesise findings.
Findings A small number of papers were found, which were of mixed quality.
Originality/value The existing research is limited in both quantity and quality. Although most participants
from the existing research described seclusion as mostly negative with the potential for causing
iatrogenic harm, some described more positive experiences, often in the context of compassionate
interactions with staff.
Keywords Qualitative, Mental health, Quality of care, Psychiatric nursing, Acute care, Systematic reviews,
Meta-analyses
Paper type Literature review
Summary statement
Why is this research or review needed?
The use of seclusion is common within mental health services but there is an absence of
evidence for the purported theoretical rationale for its use.
Studies of the experiences of individuals placed in seclusion are small in number, of mixed
quality and with mixed findings.
A systematic literature review and meta-synthesis of the existing qualitative literature
investigating the lived experience of seclusion for adults with mental health difficulties was
conducted, to synthesise the existing evidence base and make suggestions for future
developments in research and practice.
What are the key findings?
The existing research is limited both in quantity and quality.
Despite the limitations of existing research, the evidence does not support the purported
theoretical rationale for the therapeutic use of seclusion. This poses a significant challenge to
a common practice within mental health settings.
Received 6 April 2016
Revised 1 September 2016
5 September 2016
6 September 2016
Accepted 11 November 2016
Amy Mellow is based at the
Department of Clinical
Psychology, University of
Lincoln, Lincoln, UK and
Department of Clinical
Psychology, University of
Nottingham, Nottingham, UK.
Anna Tickle is a Clinical
Psychologist at the Community
Learning Disability Team,
Nottinghamshire Healthcare
NHS Foundation Trust,
Nottingham, UK and
Institute of Health, Work and
Organisations, University of
Nottingham, Nottingham, UK.
Michael Rennoldson is a
Lecturer at the Department of
Psychology, Nottingham Trent
University, Nottingham, UK.
DOI 10.1108/MHRJ-04-2016-0007 VOL. 22 NO. 1 2017, pp. 1-15, © Emerald Publishing Limited, ISSN 1361-9322
j
MENTALHEALTH REVIEW JOURNAL
j
PAG E 1

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