Factors Associated with Seclusion Use in Forensic Mental Health Settings: An Integrative Review

Seclusion is a restrictive practice used to protect the person or others from harm, however can result in trauma-related harm. While interventions to reduce seclusion have been successful, use in forensic mental health remains high. This integrative review aims to explore factors associated with the duration and frequency of seclusion in forensic mental health settings and determine sex differences in seclusion use. Results indicate that common factors associated with the use of seclusion in forensic mental health settings are younger age, diagnosis of psychotic disorder or personality disorder, and previous seclusion. Sex differences are inconsistent. Common reasons for initiating seclusion relate to actual violence and threats of violence. There is a lack of contemporary literature and current research has not considered how sex may affect seclusion use. Further research is required to identify specific risk factors for males and females and test timely and appropriate interventions to help reduce seclusion use in forensic mental health settings.