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Understanding staff perceptions on adolescent seclusions
  1. Carol Vidal,
  2. Elizabeth K Reynolds
  1. Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
  1. Correspondence to Dr Carol Vidal, Johns Hopkins, Baltimore, Maryland 21205, USA; cvidal2{at}

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Commentary on: Yurtbasi MK, Melvin G, Pavlou C, Gordon M. Staff perspectives on the effects of seclusion in adolescent psychiatric inpatient care. Int J Ment Health Nurs. 2023 Apr;32(2):567–578. doi: 10.1111/inm.13102. Epub 2022 Dec 15.

Implications for clinical practice and research

  • Nursing staff find adolescent seclusions necessary but also experience related guilt and self-doubt.

  • Seclusion protocols in adolescent psychiatric units should include alternatives to seclusion and debriefing processes.


Seclusions cause distress in patients and lead to negative outcomes, including death. Growing research demonstrates that seclusion rates vary by age, sex, race, diagnosis and personal history of adverse events.1 In fact, seclusion rates among youth are higher than among adults. While research involving staff in adult inpatient psychiatric units demonstrates that staff and patients experience negative reactions,2 more specific research is needed related to staff in …

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  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.