Suffering caused by seclusion never ceases. People in extreme distress placed in solitary confinement in psychiatric hospitals.
Suffering caused by seclusion never ceases
Catherine Jones’ experience of seclusion as a mental health inpatient suggests the practice is far from benign.
The United Nations brands it torture and an abuse of human rights.
The National Mental Health Commission wants it phased out entirely. The NSW Mental Health Commission wants to see its use radically curtailed or even eliminated. Ethical psychiatrists are repulsed by it.
If I had my way, it would be made illegal and its perpetrators charged with criminal assault and de-registered by their respective professional bodies.
“I have regular nightmares about it. I wake at 5am, rigid, in a cold sweat and feeling sick to the stomach.”
It is “seclusion” and while it sounds benign, it is anything but.
Seclusion, to me, is the act of restraining, sometimes aggressively, another human being before locking them in a tiny, bare cell, with nothing but a mattress on the floor, usually for hours on end. In the worst instances, not only are victims confined in these cage-like cells, but shackled there as well, like animals.
The shackling is called “restraint”, another Orwellian term that our public mental health system is so adept at inventing, like “primary carer” in place of next-of-kin and “consumer” for those with a mental illness.
As Fairfax Media health editor Amy Corderoy revealed on Sunday, this brutal practice is even happening to our most vulnerable, emotionally disturbed children. That the seclusion rate varies so wildly between psychiatric wards in NSW indicates seclusion is being broadly abused by staff in some public hospitals and not being used for the purpose for which it was allegedly designed.
My experience is part of the statistics.
Last July, when I sought help in a time of need from the local public psychiatric hospital, all I received was a horrific experience of “seclusion”.
The night I admitted myself, the admitting doctor granted me voluntary status, which means I was considered neither mentally ill nor disordered under the Mental Health Act, so I was free to leave if I chose.
I was physically assaulted by six nurses at 3am after waiting more than six hours for a bed in a ward.
I will swear until the day I die I did nothing to provoke this assault except be in a place where assaults of this kind are an entrenched and accepted part of the culture.
They surrounded me, grabbed me and brutally threw me to the ground before holding me down. One tore off my pants and injected me – with what, I still don’t know – not, as you would expect in the buttock or upper thigh, but the inter-gluteal cleft (my inner buttock). They seemed to relish and delight in this attack.
I was never given the option of a dignified injection or indeed to be treated like a human being.
This assault was followed by three hours locked in seclusion. If that was not traumatising enough, despite increasingly desperate pleas to use a toilet, I was left there until I wet myself. As I sobbed out of humiliation, two nurses involved in the original assault laughed at my distress through the glass observation window of the seclusion cell.
This experience had a devastating effect on me. I have regular nightmares about it. I wake at 5am, rigid, in a cold sweat and feeling sick to the stomach; particularly about my debasement, the theft of my dignity and my powerlessness to stop the assault. I already had post-traumatic stress disorder, now it is worse.
If assaults like this happened in general hospital wards there would be a public outcry.
But because they only happen to people with mental illnesses, the broader community has been unaware that these practices occur.
Public psychiatric staff use all sorts of justifications for seclusion and restraint: that the mentally ill are a threat, that this inhumane treatment is necessary, and myriad other excuses designed to blame seclusion victims for what I believe is essentially a reprehensible assault inflicted by staff.
I have never seen seclusion used for the purpose for which it is allegedly designed – only as punishment, a means of control and intimidation. I have never seen a patient behave in a way that would warrant it and I have had five admissions to public hospitals over 16 years.
Peer-reviewed studies have shown that seclusion events are usually caused by dysfunctional staff who provoke angry or distressed responses in patients. There always is an alternative, such as quietly talking to a patient to calm them.
In my case, the hospital added insult to injury. I lodged a formal complaint with the Health Care Complaints Commission about my experience. It launched an attack on my credibility, making out that I was so mentally ill, I deserved what happened to me. They went so far as to claim that the assault was a “delusion”.
This is despite the fact that the hospital’s own admitting psychiatrist had granted me voluntary status under the Mental Health Act, meaning I was far from delusional at the time.
Dealing with that was almost as traumatising as the seclusion itself. Eventually, after my complaint went to resolution, I received a neutral statement from the local health district chief executive, neither admitting wrongdoing nor apologising for my trauma, but merely stating it was “clear I had a problem with the care” I had received.
Seclusion and restraint need to be outlawed. The damage these abusive practices are inflicting on already damaged, vulnerable people cannot be understated.
The UN calls them torture for good reason. They are the antithesis of good health care and need to be confined to the dustbin of history.
Catherine Jones is a freelance journalist.
This article is from America but rest assured it is EXACTLY the same treatment in Britain today. Barbaric and Dickensian.