Seclusion: punitive or protective?

Seclusion has an uncertain standing in contemporary forensic psychiatric pr actice. It is not defined in statute but the Code of Practice to the Mental Health Act 1983 refers to it as 'the supervised confinement of a patient i n a room, which may be locked, to protect others from significant harm'. A questionnaire, designed to survey attitudes to and views of the practice of Seclusion, was sent to consultants an non-training grade doctors in the three maximum-security hospitals in England and to consultants at medium-se curity units in southern England. The overall response rate was 78%. While the majority who replied were clear that seclusion was not a form of punish ment, the views as to whether it had any therapeutic benefit were far more equivocal. There was majority support for its continued use to prevent harm to others.