Long-term segregation and seclusion for people with an intellectual disability and/or autism in hospitals: critique of the current state of affairs
Abstract
In November 2023, the Department of Health and Social Care published guidance, entitled 'Baroness Hollins' Final Report: My Heart Breaks - Solitary Confinement in Hospital Has no Therapeutic Benefit for People with a Learning Disability and Autistic People'. The report's commendable analysis of the problems and identification of the areas where practice should be improved is unfortunately not matched by many of its recommendations, which appear to be contrary to evidence-based approaches. The concerns are wide-ranging, from the use of the term 'solitary confinement' for current long-term segregation (LTS) and seclusion, to presumption that all LTS and seclusion is bad, to holding clinicians (mainly psychiatrists) responsible for events beyond their locus of control. Importantly, there is a no guidance on how to practically deliver the recommendations in an evidence-based manner. This Feature critically appraises the report, to provide a comprehensive summary outlining potential positive impacts, identifying specific concerns and reflecting on best practice going forward.
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Date
2024-12
Type
Article
Subject
Learning Disabilities
Collections
Citation
Tromans SJ, Sawhney I, Odiyoor M, de Villiers J, McCarthy J, Boer H, Alexander R, Courtenay K, Wallace S, Gangadharan S, Roy A, Blake A, Purandare K, Iyer A, Laugharne R, Weisner V, Shankar R. Long-term segregation and seclusion for people with an intellectual disability and/or autism in hospitals: critique of the current state of affairs. Br J Psychiatry. 2024 Dec 4:1-8. doi: 10.1192/bjp.2024.211. Epub ahead of print. PMID: 39629607.
Journal / Source Title
British Journal of Psychiatry
DOI
10.1192/bjp.2024.211
PMID
39629607
Publisher
Cambridge University Press
Publisher’s URL
https://pubmed.ncbi.nlm.nih.gov/39629607/