Issues in Mental Health Nursing, 34:317–324, 2013 Copyright © 2013 Informa Healthcare USA, Inc. ISSN: 0161-2840 print / 1096-4673 online DOI: 10.3109/01612840.2012.753558 The Experience of Seclusion and Restraint in Psychiatric Settings: Perspectives of Patients Caroline Larue, PhD, Associate professor Fernand Seguin research center and Quebec NursingIntervention Research Network Alexandre Dumais, PhD, psychiatrist Institut Philippe Pinel research center, Montr´ eal, Quebec, Canada Richard Boyer, PhD Fernand Seguin research center, Faculty of Medecine, Montr´ eal, Quebec, Canada Marie-H´ el` ene Goulet, PhD (cand.) Fernand Seguin research center and Quebec Nursing Intervention Research Network, Montr´ eal, Quebec, Canada Jean-Pierre Bonin, PhD Fernand Seguin research center and Quebec NursingIntervention Research Network, Montreal, Quebec, Canada Nathalie Baba, master student Fernand Seguin research center, Montr´ eal, Quebec, Canada Many studies report that the use of seclusion and restraint (SR) is experienced negatively by patients who experience feelings of shame, helplessness, and humiliation, and may relive previous trauma events. Since 2000, in Qu´ ebec, exceptional measures like SR have been framed by a protocol. This protocol provides health care teams with guidelines for relieving, containing, and reduc- ing the suffering caused by SR. We have no knowledge, however, about the views of patients regarding application of the protocol. This study aims to understand the perception of patients regarding application of the SR protocol. For this purpose, a questionnaire was presented to patients (n = 50) who experienced an episode of SR in a psychiatric hospital in Canada. Results show that patients had a nuanced perception of SR: Some felt that SR was a help- ful measure, while others felt that SR was not a helpful measure. Patients tended to agree with statements related to the comfort and safety of seclusion rooms and the meeting of their physical needs. Regarding support, they suggested relational, drug, and en- vironmental interventions to prevent seclusion. Finally, nearly all patients perceived that the health care team did not follow-up with the patients after the experience; such follow-up is essential for reconstructing a sometimes confusing event. Address correspondence to Caroline Larue, Montreal Uni- versity, Faculty of Nursing Science, 2375 Chemin de la Cˆ ote Sainte Catherine, Montr´ eal, Quebec, H3T 1A8 Canada. E-mail: caroline.larue@umontreal.ca REVIEW OF THE LITERATURE Studies of psychiatric inpatients have cast light on many negative and complex aspects entailed in the use of seclusion with or without restraint (SR). Many patients placed in seclusion are left with negative views of the event. Studies report feelings of anger and fear (Donat, 2002; Frueh et al., 2005; Kontio et al., 2012); the recalling of traumatic memories or of having ex- perienced trauma (Cano, Boyer, Garnier, Michel, & Belzeaux, 2011; Haw, Stubbs, Bickle, & Stewart, 2011); and feelings of abandonment and isolation (Bonner, Lowe, Rawcliffe, & Wellman, 2002; Holmes, Kennedy, & Perron, 2004; Lazarus, 2001; Mayers, Keet, Winkler, & Flisher, 2011; Paterson & Duxbury, 2007; Wilknis, Hunter, & Silverstein, 2004). Various studies also report an increase in violent acts and risk of injury for both patient and staff during SR episodes (Paterson & Duxbury, 2007; Weiss, Altimari, Blint, & Megan, 1998). As a result, over the past 20 years, legislation has been en- acted in different jurisdictions to establish practice guidelines for SR episodes. In Quebec, the Minist` ere de la Sant´ e et des Services sociaux (MSSS) has asked health facilities to draw up procedures in accordance with the following principles: the measures must be exceptional, taken as a last resort, be the least restrictive possible, and be subject to monitoring (MSSS, 2002). Section 118.1 of the amended Act Respecting Health Services and Social Services provides a general definition of control 317