Seclusion practice in a Canadian forensic psychiatric hospital.
In this study, seclusion practice was examined in a multilevel, secure psychiatric hospital, serving federally sentenced individuals in the Prairie Region, as defined by the Correctional Service of Canada. Between August 1996 and February 1999, 183 patients (27.7% of total admissions) were secluded on 306 occasions. The mean duration of seclusion was 90.3 hours (minimum I hour; maximum 908 hours). A higher proportion of female patients (60%) was secluded than of male patients (25%). Sixty-five percent of the patients were secluded once, 29.5 percent two to four times, and 5.5 percent more than four times. Suicidal threats and self-harm gestures were the reasons for initiating seclusion in 27.4 percent of cases. Patients with diagnosed substance-related disorders accounted for 40.8 percent of all seclusion episodes, whereas those with schizophrenia and related psychoses accounted for 28.1 percent. These findings suggest that seclusion remains a relatively common intervention in some disturbed patients in a forensic setting.