New Zealand Human Rights Commission Submission to the CAT in relation to NZ’s 6th
periodic review
continuing to use seclusion at much higher rates than the rest of the country. Māori
are significantly more likely than non-Māori to experience seclusion. In 2013 of the
768 people (aged 20 to 64) secluded in adult services, 32 percent were Māori.96
179.
There have been improvements in reporting and transparency around the use of
seclusion, including closer monitoring and regular publication of data. The Ministry
of Health has published guidance on the use of seclusion and night safety procedures
in mental health inpatient services. The Ministry also advises that further guidelines
on the use of restraint and seclusion practices are planned for 2015, which will have
an increased emphasis on a human rights approach to the provision of treatment and
the continued reduction of restrictive practices such as seclusion and restraint.
However, there are still indications that a small number of patients are secluded for
lengthy periods.
180.
The Canterbury DHB (“CDHB”) has acknowledged that seclusion is not therapeutic
and can have a traumatizing effect. It has made a concerted effort of the past five
years to eliminate the use of seclusion in their facilities.
181.
CDHB has adopted an approach based on the Six Core Strategies©97 to work towards
seclusion elimination. This process includes:
Leadership; clinical leaders are actively involved with staff in the
implementation of new models of care including supporting alternatives to
seclusion. Environmental changes have taken place which has allowed the
development of small high care areas where staff are able to provide support and
treatment for highly distressed consumers.
Use of data: Before implementing seclusion reduction strategies a number of
staff raised concerns that less seclusion use would increase risk to consumers and
staff. Data has shown, however, that as seclusion use has reduced so have injuries
to consumers and staff. This data is a powerful motivator for all staff.
Workforce Development; Training and supporting clinicians in the use of all
therapeutic activities which support consumers with managing their distress is
part of the CDHB training programme.
96
Sensory modulation is one of the
Ibid.
United States of America by the National Association of State Mental Health Program Directors Medical
Directors Council (NASMHPD)
97
68