Seclusion Room

I HATE THOSE PUSH BUTTON FLUSHERS, THEY ALWAYS LEAKED OUT WATER WHEN YOU PUSHED THEM! EEWW!!!

I bet many a turd had been flung against the wall and door, here.

Java... I've never had a problem with leaking water
Yaggy... considering that happens even in public bathrooms... I honestly don't know how females get urine on the damn toliet seat- let alone how they get shit all over the bathroom!

in a seclusion room there were never toilets nor sinks .. the room had a mattress on the floor that'a all the window was to observe the patient the bathroom was on the other side of the locked seclusion door.

I have never seen a seclusion room with rubber walls. when a patient was placed in lds(locked door seclusion) they were placed in there for several hours and if they were in need of relieving themselves they were able to with a number of people to stand watch. and then placed back in seclusion until a cooling down period was effective..

Oh, they are out there. I had one made back in 1990 or so. Baker's Pink, too! :-) I worked with a gentleman who was very strong and used to hurt staff and other clients when he became agitated (which happened quite easily), so we wanted to use a time out room to decrease the injuries to both him and staff when they were trying to get him to calm down after he hurt someone. The first time we tried it, he beat his head against the (solid) wall, so I had them pad it top to bottom. He then tore the padding out with his teeth and hit his head against the wall again, so I had them do some super-dee-duper unrippable padding. Unfortunately, he just started to eat his arms when he couldn't hit his head against anything solid, so we had to take him out and wrestle with him anyway. :-(

But once he understood that we weren't trying to hurt him when he was out of control, that we were just helping him calm down and learn to control himself, he gradually got better and better until I understand he is currently living in a community group home somewhere and doing quite well. :-)

Those of you who are critical of seclusion really ought to go one-to-one with someone who can't control themself and is twice your size and thinks you are trying to kill or hurt them. It gives you a slightly better perspective of the various ways people use to cope with difficult situations. There is significantly less restraint and seclusion used these days, but most of it is because of the psychotropic medications someone was slamming a month or two ago. Again, here is a devil's choice - do you want people drugged or do you want them restrained? Spend a week with someone who is paranoid and needs medication and isn't taking it - you'll have an interesting and new perspective, I can almost guarantee you. :-)

Lynne,
I agree with you wholeheartedly there... before my father passed away, while he was in the hospital, they had his hands tied with a posey. He fought so hard for so long to get his hands free, I believe he used his strength up and had no fight left for fighting for his life. It was very sad and difficult to watch.

there is no such thing as padded rooms..well at least in canada.

I shoulda taken a picture of the one that I mentioned in one of the above comments, but, as I said, the gentleman for whom it was initially designed ripped it apart after our first trial. We finally took the padding out because the other gentleman who used to require short time-out periods back then would, em, er, uh, well, use the padded wall to relieve himself, just to irritate us, so we took out the padding and just left it a simple little wooden-walled time-out room.

Of course, a "simple little time-out room" has so many legal specifications you can't believe it, as it rightly should. It has to be a certain number of square feet and you need adequate ventilation and lighting and temperature control and you must be able to see the person at all times in case they try to hurt themself or become ill, and you can't latch it shut - it has to be set up so that if the person outside the room walks away, the door must automatically swing open. That's so they don't place people in there and just walk away and leave them for long periods of time, like used to happen in the bad old days before time-out rooms were better regulated.

I haven't needed a time-out room for a client for probably 15+ years - in that short of a time we have been more effective in our techniques, we start more training and education at a younger age, there are more sophisticated behavioral programs, and there are better medications if there are concomitant psychiatric issues. And that's a very good thing to be able to say. :-)

A time-out room is not supposed to be used as an aversive intervention - it is used to remove someone from a reinforcing environment for a SHORT period of time or to give them a chance to be somewhere they can work on calming themself down. It is generally used for more severe behavioral outbursts, such as aggression against others, and this is even further extended to tissue-damaging aggression against others, not just a slap here or there. This sounds like semantics, but it is an important distinction both legally and clinically.

If you have the time-out room door set up so that when you walk away it will automatically swing open, it prevents a staff person from leaving a client in time-out for a lengthy amount of time. After a certain amount of time has passed and the person is still in the time-out room it becomes obvious you are either using the time-out room because you are angry at the person (retribution) or you want them "out of the way" (staff convenience), and neither one of them is therapeutic. If the staff person has to stand at the door to keep it latched from the outside it means they have to remain in the immediate area, which means they won't be tempted to walk away to do something else, possibly lengthening the amount of time the person is in time-out. When time-out is used there are generally a set of "release criteria," such as being calm and/or quiet for 15 seconds before the door is open. If the staff walks away they can't tell when the client is ready to leave the time-out room, and it may only be a minute or two that the client actually needed to calm down. As well, the staff person needs to be right at the door to either hear or see if the client gets into trouble - if they have a seizure, have a heart attack, engage in self-injurious behavior and need to be removed, etc. I don't believe I ever allowed anyone in time-out past 30 minutes tops - and of course that was only if they continued to threaten others or actually tried to harm someone again when the door was opened. And even on my roughest unit with some pretty tough gentlemen I don't believe we used it for more than a handful of times per month ever.

This is different than a seclusion room. Seclusion rooms are used in mental health facilities and are used in lieu of straitjackets or 4-point restraint. They are utilized if someone is severely agitated or aggressive and needs to be apart from others but won't hurt themself if left alone. The door to the room is locked and the person is left in the room with some form of monitoring, although monitoring is a relatively new requirement. I would certainly support a seclusion room if the only alternative was a mechanical restraint (straitjacket or 4- or 5-point restraint) or chemical restraint (almost always antipsychotics these days). It gives the person the option to calm themself down without being restrained or drugged, and I think that is a very good thing.

There are many times when people are so out of control that they may need one of the more restrictive options, such as if they are huge and strong or if they try to hurt themself and won't stop. Everybody in the general public hates straitjackets and drugs until they have a 300-pound person throwing a bed or file cabinet in their general direction. That isn't meant to be a negative comment toward people who are in such a terrible situation that they have lost control; it is meant for those people who seem to be offended that restraint, meds, or seclusion are ever used without realizing the alternative, which is getting your butt badly kicked or possibly losing your life.

,yne you must be a psych tech, I am too. colorado state home and trainingg school, state hospital pueblo, patton state, fairview state,pacific state, (lanterman)riverside county,and pribate owned ones. and these pics are real good mott, best regards.

Licensed clinical psych, but same dif. ;-)

And dang! You get around as much as I do!

Well ... first time posting for me - unfortunatly on a some-what dead topic, it would seem.

I work for our county's PHF. We have two seclusion rooms - both video monitored in the Staff's Station 24/7. In response to Skye's erronous 'facts,' there are indeed *ahem* facilities in both. One piece units of stainless steel much like those in modern county jail cells.

Granted, compared to Lynne I am hardly a poisoned tongue, er, fingers where the technicalities are involved, but I felt compelled to comment.

This is why I don't suck my thumb - I'd kill myself. ;-)

RE: Padded rooms
This place was only closed in 2000.
3rd pic down
http://www.forgottenoh...can/franciscan4.html

Lynne,

I just wanted to thank you for your posts! Maybe some of the people that think padded rooms were used as cruel and unusual punishment will finally realize that that is, in fact, not the case at all! I just visited my friends dad (he's a teacher in an elementary school) and he was telling me about a boy that would become so violent with other students, teachers, and himself that they decided to put a padded room into the school for his safety. I was at the school so he showed me the room and he was explaining how the boy would start beating his head against the walls before they had the room padded and he said that he knew he needed to take action to be sure this boy would be safe in school, even if it was to be safe from himself. I just say, "Thank goodness!" for people like him because ever since they put in that room, it takes the boy much less time to cool down than it did previously. So, that room with the help of the psychiatrist the school brought in has helped that boy so much and that is HUGE! It has, I'm sure, changed the course this boys life will take because of the way people cared for him. And I think that that is what counts the most!

Working with an agency for almost 8 years I have learned so much. Here we have restraint methods that have to be carefully taught and practiced. We also have rooms with blue padded matts in them. And yes these rooms have certain specifications like no locks and a window to see the behavioral client. They can be left in there for as long as needed but must be asked as to their specific bahavior plan if they are ok. Trust me when someone is in a 4 person supine resraint then need time to cool off. Great picks. Some of the pictures help me to understand where the clients I take care of come from. What a wonderful life they live now.

acuteward, thanks for the link, that hospital is in my hometown. And a side note regarding the behavioral patients, yes, they are at times extremely dangerous.

ok heres the thing.. this being a childrens hospital... wouldnt you think the staff would better be able to get padded walls as a means of protection... i mean i just get the feeling that these kids wher just allowed to bang their heads against the wall wich im sorry is abuse self inflicted or not i think they should protect them against themselves but seeings how staff beat kids here i doubt they cared much ... any comments email to justicedrems24@aol.com

WHAT????????????????????????????????????????????????????, QUICK MUST NOT TYPE, WILL BE BAD SITUATION!!!!!
SPIDERGIRL, really do you think that these places did not do the best they could to try to protect the people who lived there?

This is a hotel compared to B.C.D.C.

Just food for thought
www.paddedsurfaces.com
www.goldmedalsafetypadding.com

Found these on arcat

Well, I must say, if I ever had landed in that place I would have seriously misbehaved like every second of the day just so they'd put me in a room where i could use a toilet without constant observation. Seriously, throw me in isolation, I don't care. I least I'd have some peace while I... Well, you get the idea.

Modern day college dorm room?

The sink is placed right in front of the door. Anybody washing their hands would get smacked.

this place is just awful. all these sharp edges its a suicides fantasy .

Reminds me of a prison cell

what happens if a person is found dead in a seclusion room?

Dear lord lynne, he started EATING his arms!!!??? Holy S&&*%!!!!! I've tasted my arms but never EATEN them....never!!!

Looks like the pigeons have been properly using the toilet =)

Ok, if you want my 2 cents, it does rather closely resemble rooms at the JD center my developmental psych class toured. Of course, according to the program schedule, the kids were hardly in the rooms during the day unless severe behavior warranted it.

This actually doesn't look all that bad for a seclusion room. It has toilet facilities, light and ventilation. The ones I've seen were completely bare; then again, in the places I've been people aren't generally kept in the "time out room" for an extended length of time, as they appear to have been in this place.

The Quiet Room

She couldn’t comprehend the hospital’s rules. She went into her bedroom to escape the racket of people cackling, shoes squeaking, Bob Barker barking from the T.V. set, and the fax shrilly ringing. The noise hurt her ears. The next thing she knew a crowd of men stormed her room. Pinning her limbs behind her back they carried her kicking and screaming to a dirty, barren room. Unceremoniously, they dumped her on a gym mat, rushed out and locked the door.

She was bewildered as to why they would play a trick on her. She panicked even more because the walls were closing in on her. Banging on the door she screamed in vain to be freed.

She thought they wanted her to do gymnastics on the gym mat. After several handsprings she found instead the men surged back in. She fought them tooth and nail, but was overpowered. They forced her on a table and tied her in four point restraints. Outnumbered but not defeated she escaped twice, shouting gleefully she was the great Houdini reincarnate. She thought surely her cleverness would win her release. Each time they tied the leather tighter until she was truly trapped.

She thought that they wanted her to pee on herself, and so she did. They just took her gown away. She laid naked and spread eagle for all to see.

After a time her terror grew so great that she forgot where she was. She forgot she was in restraints.

She thought a great epidemic had swept the nation. Stricken, contagious and in isolation, paralyzed and dying, she was in desperate need of someone to hold her hand and comfort her, to tell her she was not alone. A worried nurse peeked in the window in the door, but didn’t stop. Because of the epidemic the staff shortage was severe. They too were dying.

She passed into a soft green space. She watched her soul shine and ascend toward Heaven. Before entering Heaven’s gate her soul was examined and found wanting. She crashed into the depths of Hell.


Later when she felt more cognizant her doctor came to visit. She stretched her hand to touch his hand. He stepped back swiftly, and her heart plummeted.

By the time she left seclusion the other patients were afraid of her. Her moans and screams of pain had echoed through the halls at night and sounded animal not human.

I wish someone would have thought to hold my hand.