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Locked doors in acute inpatient psychiatry: a literature review

van der Merwe, M., Bowers, L., Jones, J. , Simpson, A. & Haglund, K. (2009). Locked doors in acute inpatient psychiatry: a literature review. Journal of Psychiatric and Mental Health Nursing, 16(3), pp. 293-299. doi: 10.1111/j.1365-2850.2008.01378.x


Background: Many acute inpatient psychiatric wards in the UK are permanently locked, although this is contrary to the current Mental Health Act Code of Practice.

Aim: To conduct a literature review of empirical articles concerning locked doors in acute psychiatric inpatient wards.

Method: An extensive literature search was performed in SAGE Journals Online, EBM Reviews, BNI, CINAHL, EMBASE Psychiatry, International Bibliography of the Social Sciences, Ovid MEDLINE(R), PsycINFO and Google, using the search terms “open$”, “close$”, “$lock$”, “door”, “ward”, “hospital”, “psychiatr”, “mental health”, “inpatient” and “asylum”.

Findings: A total of 11 empirical papers were included in the review. Both staff and patients reported advantages (e.g. preventing illegal substances from entering the ward and preventing patients from absconding and harming themselves or others) and disadvantages (e.g. making patients feel depressed, confined and creating extra work for staff) regarding locked doors. Locked wards were associated with increased patient aggression, poorer satisfaction with treatment and more severe symptoms.

Conclusion: The limited literature available showed the urgent need for research to determine the real effects of locked doors in inpatient psychiatry.

Publication Type: Article
Additional Information: This is the peer reviewed version of the following article: VAN DER MERWE, M., BOWERS, L., JONES, J., SIMPSON, A. and HAGLUND, K. (2009), Locked doors in acute inpatient psychiatry: a literature review. Journal of Psychiatric and Mental Health Nursing, 16: 293–299, which has been published in final form at This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
Publisher Keywords: acute psychiatric inpatient; closed ward; locked door; locked door policy; psychiatric inpatient ward; ward door
Subjects: R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
R Medicine > RT Nursing
Departments: School of Health & Psychological Sciences > Nursing
SWORD Depositor:
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