Padded cell

A padded cell or seclusion room is a controversial enclosure used in a psychiatric hospital or a special education setting in a private or public school, in which there are cushions lining the walls and sometimes has a cushioned floor as well. The padding is an attempt to prevent patients from hurting themselves by hitting their head (or other body parts) on the hard surface of the walls. In most cases, an individual's placement in a padded cell is involuntary.

Other names used are rubber room,^[1] padded room, time-out room, calming room, quiet room, or personal safety room.

Use

The length of time patients are kept in a padded cell varies greatly. Some patients remained locked in a padded cell for several days. A patient might also be made to wear a straitjacket if they are considered at risk of self-harm.^{[citation needed]}

The use of padded cells and straitjackets declined drastically following the introduction of psychotropic drugs in the 1950s. Personal Safety Rooms are still used throughout the world and can be beneficial in providing a safe environment for not only occupants but also staff, and can prevent work-related injuries in the facilities.^{[citation needed]}

A reconstructed padded cell is maintained at the Mental Health Museum, Fieldhead Hospital, Wakefield, UK.^[2]^[3]

Current practice

Seclusion room in a psychiatric hospital in Germany

In the UK, seclusion is defined by the Mental Health Act 1983 Code of Practice as: "the supervised confinement of a patient in a room, which may be locked. Its sole aim is to contain severely disturbed behavior that is likely to cause harm to others."^[4] The Code of Practice (paragraph 26.109) says that a seclusion room should only be used for that purpose and should have the following features^[5] as summarized in the guide published by the Care Quality Commission:^[6]

"Allow for communication with the patient when the patient is in the room and the door is locked, for example, via an intercom"
"Include limited furnishings, which should include a bed, pillow, mattress and blanket or covering"
"Have no apparent safety hazards"
"Have robust, reinforced window(s) that provide natural light (where possible the window should be positioned to enable a view outside)"
"Have externally controlled lighting, including a main light and subdued lighting for night time"
"Have robust door(s) which open outwards"
"Have externally controlled heating and/or air conditioning, which enables those observing the patient to monitor the room temperature"
"Have no blind spots and alternate viewing panels should be available where required"
"Always have a clock visible to the patient from within the room"
"Have access to toilet and washing facilities"

Criticism of seclusion and use of seclusion rooms

Many have said that the use of seclusion causes more harm than good. There is evidence that seclusion rooms and padded cells are used as punishment for minor behavioral problems in public schools and special education programs. There have also been cases of students being locked in seclusion rooms only to be found covered in blood later.^[7]^[8]