Case study 

Applying an ergonomics approach to the reduction of seclusion in a rural mental health inpatient unit – a case study

Waring C.
Ergonomics Australia – HFESA 2011 Conference Edition, 2011 11:44.

Abstract

Background: Mental health inpatient units provide care to patients experiencing acute mental health episodes. Some patients present with behaviours that place themselves, staff and others at risk. An accepted practice for dealing with this behaviour has been to place the patient in solitary confinement known as seclusion, which is a coercive practice. Internationally, reducing the use of seclusion has gained interest. In Australia, the Government is leading widespread changes in mental health including emphasis on the reduction of seclusion. The Victorian Department of Health has supported several projects to reduce seclusion in public inpatient mental health units; this project was undertaken in a rural unit. Aims: The aims of the project were to minimise the number of seclusion events and the adverse effects of seclusion. Method: Key factors contributing to seclusion episodes were identified through an in-depth analysis of each seclusion event. Features of the patient journey leading to the seclusion were investigated using an information gathering tool. This information was collated into factors related to people, systems and environment. Results and conclusions: While some of the identified factors were common to other projects, others were specifically relevant to this rural mental health service. The outcomes from the interventions commenced were a significant reduction in the incidence of seclusion and a reduction of the duration of patient time in seclusion. In conclusion, applying an ergonomic approach provided a rich source of information and evidence for addressing issues specific to this service. Other mental health services may find different factors relevant to their situation.

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