THE RIGHTS OF ADULTS
TO MOVE FREELY ON A HOSPITAL WARD
Staff have a number of methods to limit the movement of adult patients on a hospital ward. Some of these methods require patient consent, others do not if you are not sure if you have been properly restricted, ask to speak to the Human Rights Officer.
I. ROOM PLAN
A room plan is a form of treatment in which a schedule is created which dictates when a patient shall spend time in and out of a room on the ward, such as a bedroom. The schedule typically changes over the course of days if the patient abides by the plan, the time spent in the room gradually decreased and the time spent on the ward increased. The goal of a room plan is to cautiously bring a patient into life on the ward, while maintaining behavior that meets staff standards. Because a room plan is a form of treatment, it can only be used with the consent of the patient (if competent to consent) or a guardian (with the authority to consent to a room plan). Also, like other forms of treatment, it must be terminated if the patient withdraws consent.
II. QUIET ROOM
The quiet room is a room, usually empty, to which a patient goes to experience time away from staff and other patients. Use of the quiet room is voluntary and may not be ordered by staff. While staff may suggest or even encourage a patient to use the quiet room, the patient may refuse such a request. A patient has the right to leave the quiet room at any time.
III. SECLUSION
Seclusion is the placement of a patient alone in a room or enclosed space so that:
While seclusion does not require patient consent, staff may only place a patient in seclusion in an emergency, such as the occurrence of or serious imminent threat of extreme violence or self-destructive behavior. Seclusion may be used only when less restrictive alternatives have failed or are not possible. When the patient no longer meets the standard for seclusion, he or she must be released.
IV. OTHER RESTRICTIONS OF MOVEMENT ON A WARD
At some facilities, staff limit the movement of patients on a ward through the use of other restrictions. A patient might be restricted to the day hall, male or female end of the ward, or other common areas. The hospital may have a policy which outlines when such restrictions may be used and who must approve their use. Furthermore, unless the areas to which the patient is restricted are available to and shared by other patients, such restrictions may constitute seclusion and require an emergency prior to imposition absent patient consent.
Mental Health Legal Advisors Committee
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