■ F uture research should seek the views and experiences of service userspatients, prisoners and residents- during their time in seclusion, segregation,
or restraint. For example, did they experience their treatment as good and
caring, or as degrading and punitive? Which aspects of their confinement
did they find most difficult to deal with? What could be done to improve
these experiences? Similarly, more work needs to be done to understand
staff perceptions and concerns about the potential consequences of reducing
and eventually eliminating seclusion practices. While these concerns must
not take precedence over patients’, prisoners’ and residents’ health and
wellbeing, they do need to be acknowledged and addressed.
To the Ministry of Health /District Health Boards
■ T
he Ministry of Health and individual DHBs should be applauded for their
commitment to policies aimed at the reduction, and eventual elimination,
of seclusion. This commitment must be supported by a reassertion of why
seclusion needs to be minimised in the first place: i.e. because it is damaging,
inappropriate, not conducive to the therapeutic relationship between the
patient and their care givers, and because it has no therapeutic value. This
can be done through further training which may also help to address staff
concerns about policies to eliminate the use of seclusion.
■ T
he physical environment of seclusion units and rooms needs to be improved.
‘Low stimulus’ need not mean barren and drab. Basic furniture can and should
be introduced to rooms, especially where patients may spend longer than
a few hours in seclusion. This can be special ‘safe furniture’ designed from
tamper-proof materials aimed specifically for high risk patients. Patients
should be allowed to keep some personal belongings and provided with
something to do inside seclusion rooms.
■ C
all bells should always be located inside the room so that the patient always
has means of communicating with staff. Light switches and blind controls
should be located inside seclusion rooms unless there are compelling and
temporary reasons not to do so. Mechanisms which enable staff to override
patients’ control can be installed to allay any safety concerns. This will help
to normalise the environment and will afford the patient/client a degree of
control over their environment.
■ A
ll regular seclusion rooms should have drinking water. Where water is not
provided, better arrangements for providing it need to be made to ensure
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