Seclusion within the first 24h following admission into inpatient mental health services and associations with referral pathways, recent service contact and HoNOS ratings

IntroductionPeople 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/QuestionTo identify factors associated with seclusion within the first 24 h following admission into acute inpatient mental health services.MethodA retrospective analysis was undertaken using routinely collected data from Aotearoa New Zealand mental health services.ResultsA 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.DiscussionPeople'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 PracticeThe 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.