Young Adults' Experiences of Seclusion in Acute Mental Health Settings: A Community-Engaged Interpretive Description Study.

Abstract

Despite global calls to reduce and eliminate the practice of seclusion-confinement of a person in an isolated locked room-this practice remains frequently used among young adults. In context of limited research examining lived experiences of seclusion, this community-engaged qualitative study explores young adults' experiences of seclusion within acute mental health settings. Through a theoretical lens of Foucault's confinement, this study utilized community-engaged approaches and interpretive description methodology to guide research inquiry. People with lived experience were engaged as co-researchers through a Peer Advisory Committee. Participants (N = 17) engaged in in-depth individual interviews, sharing their experiences of seclusion. A process of reflexive thematic analysis generated four central themes: (i) seclusion experienced as dehumanizing and traumatizing; (ii) seclusion emphasized relations of power and compliance; (iii) seclusion exacerbated mental health challenges; and (iv) seclusion led to lasting consequences for mental health and well-being. Findings illustrate the considerable harms and trauma associated with seclusion, particularly amidst the developmental and mental health transitions associated with young adulthood. This research emphasizes the need for mental health systems reforms to remediate these harms associated with seclusion, including through directly integrating the voices of young people with lived experience in guiding nurses' and other health providers' practices.