Naked Social Control: Seclusion and Psychiatric Nursing in Post-Liberal Society

Abstract

Post-liberal societies have developed a matrix of social control faculties, ranging from subtle, covert, and pervasive self-regulatory doctrines, to coarse, overt, and authoritarian infringements on human emancipation and full citizenship. Psychiatric nurses (along with members of the other psychiatric disciplines, particularly medicine) are engaged in post-liberal injunctions of thoughts and behaviour. Furtive control of the psychiatric patient’s ‘self’ has been enacted traditionally through, for example, the requisites of the ‘therapeuticrelationship’ and the talking therapies. The psychiatric nurse and psychiatrist have now become administrators of ‘risk’ and arbitrators in the division of mentally disordered people into categories of ‘dangerousness’. The increasing adoption of physical removal and segregation of individuals who, as in-patients, are already incarcerated within the psychiatric system (thereby suffering a double-dose of social exclusion), is a blatant portrayal of stringent social control. The power to seclude exposes the reality of the psychiatric nurse’s role in the last instance – that of (naked) agent of social control. This paper exposes the incongruity between principles of mental health law (which optimise the promotion of wellbeing and the prevention of mental disorders), and the practice of seclusion that confines individuals, and removes their dignity.