Seclusion and restraint use should be stopped

There is currently no reliable monitoring of seclusion and restraint use in emergency departments in NSW, nor is there any routine, on-site supervision after hours in several mental health units, according to a report released by the NSW Government.

These were among a number of findings following a review into the way seclusion and restraint are used in in-patient mental health facilities and emergency departments.

The report, Review of seclusion, restraint and observation of consumers with a mental illness in NSW Health facilities, shines a light on outdated and harmful practices and points the way to a more effective and humane system. Authored by Chief Psychiatrist Dr Murray Wright, the report was commissioned after details surrounding the death of patient Miriam Merten in 2014 came to public attention in May last year.

Acting NSW Mental Health Commissioner Karen Burns said the commission was extremely pleased to see a straight-talking report, with 19 recommendations which do not shy away from the impact of seclusion and the trauma it inflicts on individuals.

“The commission unequivocally supports the reduction and elimination of seclusion and restraint practices in mental health facilities. We endorse the 19 recommendations released today, which acknowledge people’s harmful experiences of coercive practices, and set in place steps to enable the reduction and elimination of these traumatic events.

“We also welcome the $20m investment to ‘improve the therapeutic environment inside acute mental health units’. For this to be achieved, people with lived experience of mental health issues including peer workers will need to be included in all planning and decisions.

“We should expect to see people with experience of mental illness exercising decision-making and influence at every level of a mental health service. That includes being involved in decisions about their own treatment, but — as emphasised in the recommendations — it also means being involved in delivering care to others as a peer worker and in co-designing safe environments and services that promote recovery.

For further information about the review, visit NSW Health’s website.

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