Abstract：
WHAT IS KNOWN ON THE SUBJECT?: Seclusion is a harmful and traumatising intervention for people accessing mental health services. People who are subject to seclusion in inpatient mental health services often first experience this within the first 24 h following admission. There is limited research examining how recent contact with services impacts the likelihood of seclusion when people are admitted to inpatient services. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Males, Māori and Pasifika experience higher rates of seclusion within the first 24 h following inpatient admission. People perceived by clinicians as overactive, aggressive, disruptive or agitated are seven times more likely to be secluded within the first 24 h. People referred from police or justice services are three times more likely to be secluded within the first 24 h. People who had frequent contact with community mental health services prior to inpatient admission were less likely to be secluded. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The first 24 h of inpatient admission is a critical focus for eliminating the use of seclusion. Initial interactions with people recently admitted should focus on nurturing relationships and reducing distress. Mental health staff should consider the person\'s cultural needs, referral pathway, recent service contact and baseline ratings on the Health of the Nation Outcomes Scales (HoNOS) when working proactively to prevent the use of seclusion in the first 24 h following admission. Strengthening the focus on nurturing relationships, cultural understanding and non-coercive de-escalation approaches requires leadership support and strategic workforce development. ABSTRACT: Introduction People who experience seclusion in inpatient mental health services often do so within the first 24 h following admission. There is limited research examining the potential contributing factors, particularly recent contact with services. Aim/Question To identify factors associated with seclusion within the first 24 h following admission into acute inpatient mental health services. Method A retrospective analysis was undertaken using routinely collected data from Aotearoa New Zealand mental health services. Results A higher likelihood of seclusion within the first 24 h following admission was associated with: males, Māori, Pasifika, referrals from police/justice services, inpatient transfers, recent contact with crisis assessment teams and clinician perceptions of aggression, problematic substance use, cognitive problems and hallucinations or delusions. Recent contact with community mental health services was associated with a lower likelihood. Discussion People\'s cultural needs, referral pathway, recent service contact and HoNOS scores should be considered when working to prevent the use of seclusion in the first 24 h following admission. Implications for Practice The first 24 h following inpatient admission is a critical period for preventing the use of seclusion. Nurturing relationships, cultural understanding and use of non-coercive de-escalation approaches can support better outcomes for people recently admitted.
摘要：
关于这个主题的知识是什么？：隔离是对获得精神卫生服务的人的有害和创伤的干预措施。在住院精神卫生服务中隐居的人通常会在入院后的头24小时内首次经历这种情况。关于最近与服务机构的接触如何影响人们接受住院服务时隐居的可能性的研究有限。论文对现有知识有何贡献？：男性，毛利人和Pasifika在住院后的前24小时内的隐居率较高。被临床医生认为过度活跃的人，侵略性,在最初的24小时内，破坏性或烦躁不安的人被隔离的可能性要高7倍。在最初的24小时内，从警察或司法部门转介的人被隔离的可能性要高3倍。在住院之前经常与社区精神卫生服务机构接触的人不太可能被隔离。对实践有什么意义？：住院的前24小时是消除隔离使用的关键重点。与最近承认的人的初始互动应该集中在培养关系和减少痛苦上。心理健康人员应考虑人的文化需求,转诊途径,在入院后的前24小时内积极工作以防止使用隐居时，最近的服务联系人和国家健康结果量表（HONOS）的基线评级。加强对培养关系的关注，文化理解和非强制性降级方法需要领导力支持和战略劳动力发展。摘要：介绍在住院精神卫生服务中经历隐居的人通常在入院后的第一个24小时内就这样做。研究潜在影响因素的研究有限，特别是最近与服务部门的联系。目标/问题确定入院后的头24小时内与隔离相关的因素。急性住院精神卫生服务。方法使用从Aotearoa新西兰精神卫生服务机构常规收集的数据进行回顾性分析。结果入院后最初24小时内隐居的可能性较高与：男性，毛利人,帕西菲卡,警察/司法部门的转介，住院转移,最近与危机评估小组和临床医生对侵略的看法接触，有问题的物质使用，认知问题和幻觉或妄想。最近与社区精神卫生服务机构的接触可能性较低。讨论人们的文化需求，转诊途径,在工作时，应考虑最近的服务联系和HoNOS评分，以防止在入院后的前24小时内使用隐居。对实践的影响住院后的前24小时是防止使用隔离的关键时期。培养关系，文化理解和使用非强制性降级方法可以为最近被录取的人提供更好的结果。
