Abstract
Changing professionals’ attitudes toward seclusion is seen as an important condition to reduce its use. The purpose of this study was to determine whether professionals from a mental health institute in the Netherlands changed in their attitudes toward seclusion after implementation of a multifaceted seclusion reduction program. Professionals working on four acute admission wards filled in the Professional Attitudes Toward Seclusion Questionnaire (PATS-Q) before and after a seclusion reduction program. Changes were analyzed by comparing mean scores on the PATS-Q. After the program, professionals scored significantly higher on ‘ethics’ and ‘more care’. As expected, no change occurred on ‘reasons’ for the use of seclusion. In addition, no significant changes were found on ‘confidence’, ‘better care’ and ‘other care’. Significant changes in professional attitudes concerning the ethics of using seclusion and involving issues of more care were observed after a seclusion reduction program. Mental health professionals moved in the direction of ‘transformers’, indicating an increased criticism of the practice of seclusion and increased willingness to change their own use of seclusion.
Highlights
The use of seclusion is increasingly seen as controversial and reducing its use in mental health care is a priority health policy issue in many Western countries including the Netherlands [1, 2]
The purpose of this study was to determine whether professionals from a mental health institute in the Netherlands changed in their attitudes toward seclusion after implementation of a multifaceted seclusion reduction program
Significant changes in professional attitudes concerning the ethics of using seclusion and involving issues of more care were observed after a seclusion reduction program
Summary
The use of seclusion is increasingly seen as controversial and reducing its use in mental health care is a priority health policy issue in many Western countries including the Netherlands [1, 2]. Huckshorn (2006) [11] translated deep change to psychiatric practice and the aim to reduce the use of seclusion and saw a change in attitude of professionals toward seclusion as an important condition to achieve this goal. Professional attitudes and ward culture are often mentioned as important determinants in the reduction of the use of seclusion in mental health care [12,13,14,15,16,17,18,19]. Empirical evidence concerning the way to achieve attitude change of mental health professionals toward the use of seclusion is lacking [23,24,25]. Pellfolk et al [27] used the PRUQ (Perceptions of Restraints Use Questionnaire) in geriatric care Contrary to expectations, both studies did not find any change in attitudes after the training
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