In November 2023, the Department of Health and Social Care published guidance, entitled ‘Baroness Hollins’ Final Report: My Heart Breaks – Solitary Confinement in Hospital Has no Therapeutic Benefit for People with a Learning Disability and Autistic People’. The report's commendable analysis of the problems and identification of the areas where practice should be improved is unfortunately not matched by many of its recommendations, which appear to be contrary to evidence-based approaches. The concerns are wide-ranging, from the use of the term ‘solitary confinement’ for current long-term segregation (LTS) and seclusion, to presumption that all LTS and seclusion is bad, to holding clinicians (mainly psychiatrists) responsible for events beyond their locus of control. Importantly, there is a no guidance on how to practically deliver the recommendations in an evidence-based manner. This Feature critically appraises the report, to provide a comprehensive summary outlining potential positive impacts, identifying specific concerns and reflecting on best practice going forward.

2023 年 11 月，卫生和社会保健部发布了题为“Hollins 男爵夫人”最终报告：我的心碎——单独监禁在医院对学习障碍者和自闭症患者没有治疗益处”。不幸的是，该报告对问题的分析值得称赞，并确定了应该改进的实践领域，但其许多建议并未匹配，这些建议似乎与循证方法背道而驰。担忧范围很广，从使用“单独监禁”一词来指代当前的长期隔离 （LTS） 和隔离，到假设所有 LTS 和隔离都是坏的，再到让临床医生（主要是精神科医生）对超出他们控制范围的事件负责。重要的是，没有关于如何以循证方式实际提供建议的指导。此功能对报告进行了批判性评估，以提供全面的摘要，概述潜在的积极影响，确定具体问题并反思未来的最佳实践。