Which patients are secluded on an Adolescent Inpatient Unit: A retrospective study.

Glenn Alexander Melvin, Miriam Katarzyna Yurtbasi, Michael Solomon Gordon

Research output: Contribution to conferenceOther


Objective: Seclusion involves the forceful placement of an inpatient into a locked room, to control unmanageable behaviours. The use of seclusion in child and adolescent psychiatric settings is concerning particularly given its counter-therapeutic effects. In response, increasing efforts are being made to reduce or eliminate its use. The present study sought to identify patient variables associated with seclusion on an adolescent inpatient unit in order to inform future interventions that aim to reduce the practice. Methods: Retrospective data on clinical and demographic variables was gathered from inpatients admitted between 2010 and 2012, from the Stepping Stones Adolescent Psychiatric Inpatient Unit, Monash Medical Centre, Australia. The sample included all patients who were secluded during the three years; 59 secluded and 56 matched non-secluded adolescents aged between 12 and 18 years (M=15.44, SD=1.43). Using regression analyses, data on secluded and on-secluded adolescents was compared in an attempt to identify variables that were associated with seclusion.Results: The predictive model of seclusion was statistically significant (p<.01). The model included the Children's Global Assessment Scale (CGAS) score, history of aggression, psychotic disorder, attention-deficit and disruptive behaviour disorders, age, gender, and Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) total score. Of the aforementioned variables, seclusion was significantly associated with lower CGAS score, history of aggression, and psychotic disorders. It was not significantly associated with younger age, male gender, higher HoNOSCA total score or attention-deficit and disruptive behaviour disorders.Conclusion: Clinical markers that predict risk of seclusion were identified and will inform efforts to detect those who may benefit from additional intervention to prevent seclusion risk. Future research should investigate both patient and environmental variables, in order develop a multivariate framework for assessing risk of seclusion.
Original languageEnglish
Number of pages1
Publication statusPublished - 2014
EventIACAPAP 21st World Congress - Durban, South Africa
Duration: 11 Aug 201415 Aug 2014


ConferenceIACAPAP 21st World Congress
CountrySouth Africa

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