Introduction and background The Mental Welfare Commission first published guidance on the use of seclusion in 2007. The focus at that time was on restrictions being placed on people in a hospital setting and the authorisation, regulation and monitoring required to safeguard the rights of the individual. The guidance was reviewed in 2014 as it became clear that various restrictions were being applied in a range of hospital and community settings but were often not subject to any legal authorisation despite there being a clear infringement of an individual’s right to freedom of movement. The purpose of this document is to provide clear guidelines for the consideration and use of seclusion and to ensure that, where this takes place, the safety, rights and welfare of the individual are safeguarded. A Cochrane review in 2000 revealed that there was a dearth of published studies of note evaluating the value of seclusion or restraint in the management of behaviour likely to cause harm 1. However, more recently, efforts have been made to introduce information and guidance for staff in this area. Following the uncovering of abuses at Winterbourne View Hospital in 2012 2 and a critical report on the use of restraint 3, the Department of Health published ‘Positive and Proactive Care: reducing the need for restrictive interventions’ 4. This was designed to promote therapeutic environments across all adult health and social care services, with restrictive practices used as a last resort. The Royal College of Nursing produced a guide for the development of staff to be able to work in a positive and proactive way to minimise the use of restrictive practices in health and social care 5. The National Institute for Health and Care Excellence (NICE) published updated guidance in 2015 on violence and aggression: short-term management in mental health, health and community settings 6. The update took into account new information on patients’/service users’ views on the use of restrictive practices. In Scotland, the Scottish Patient Safety Programme is grounded in quality improvement methodology. ‘Violence, restraint and seclusion reduction’ is one of the change packages in the Scottish Patient Safety Programme for Mental Health. 7 Sailas EES, Fenton M (2000) Seclusion and restraint for people with serious mental illness. Cochrane Database of Systematic Reviews. Issue 1. Art. No.: CD001163 2 Department of Health (2012) DH Winterbourne View Review Concordat: programme of action. London: Department of Health, England. 3 Mind (2013) Mental health crisis care: physical restraint in crisis: a report on physical restraint in hospital settings in England. London: Mind. 4 Department of Health (2014) Positive and Proactive Care: reducing the need for restrictive interventions. London: Department of Health, England. 5 Skills for Care & Skills for Health (2014) A Positive and Proactive Workforce: a guide to workforce development for commissioners and employers seeking to minimise the use of restrictive practices in social care and health. Leeds: Skills for Care & Skills for Health. 6 National Institute for Health and Care Excellence (2015) Violence and Aggression: short-term management in mental health, health and community settings. NG10. London 7 Hall D (2016) Reducing Harm in Mental Health Settings: the Scottish Patient Safety Programme’s approach. International Society for Quality in Healthcare webinar 11 August. 1 5