The literature reveals few studies investigating the psychiatric patient's perception of seclusion and these are limited in scope. Considering the widespread controversial use of seclusion in psychiatric settings and the major role perception plans in behavior, knowledge of the patient's view of this event would seem essential to guide the nurse and other team members in treament decisions.

The theoretical framework selected for this study was Gutheil's theory of seclusion. Six research questions and a semi-structured interview schedule were developed. These were designed to explore the self-reported thoughts, emotions, and behavior of secluded patients before, during, and after seclusion.

Fifty-two voluntarily admitted adult psychiatric inpatients on four units of a state psychiatric hospital were interviewed within three days of their seclusion-room experience, in private tape-recorded interviews. Research was conducted over a five month period from November 23,1984 to May 11, 1985.

It was determined that most seclusions occurred on the evening shift and evening seclusions tended to be shorter than those on other shifts. Reasons for seclusion given by subjects were different than those given by staff.

Some differences were found in the thoughts and behavior reported by subjects by diagnosis and by first time in seclusion versus repeat experience.

Findings were related to control perceived by patients, out-of-control impulses, pathological intensity of relationships with staff and other patients, hyperesthesia, emotions, hallucinations in seclusion, changes in attitudes and behavior of staff and other patients toward subjects and changes of the subjects toward staff and other patients after seclusion as perceived by the subjects, seclusion as protection or punishment, and the need for seclusion for subjects and others as perceived by subjects.

Findings supported Gutheil's theory of seclusion as an appropriate treatment modality for patients who experienced out-of-control impulses, pathological intensity of relationships, and hyperesthesia, but suggested some seclusions might have been avoided by decreasing frustration, thus preventing anger and increasing perceived control by psychiatric patients. Forty-eight percent of the subjects reported needing the seclusion they were interviewed about.