prison, only 3 flushes of the toilet daily (depending on the prison – note also
inconsistency)43; and relying on police or prison officers to be able and available
to give a detainee their asthma inhaler when they had an asthma attack, as
inhalers could not be kept in the cell (including at Auckland Women’s ARU,
Auckland Men’s, and Wellington Police).
Whilst not doubting the goodwill of staff, they cannot always be available to
assist and it is important to have structures and procedures in place to ensure
that, to use the examples above, everyone can always access basic necessities
such as drinking water and are able to alert someone in cases of emergency or
distress or indeed if they need to use the toilet at night when their rooms are
locked. In this respect I also note the practice of locking up patients in their
bedroom at night in mental health facilities, a practice which, using the Ministry
of Health’s own definition, would constitute ‘seclusion’.
Risk aversion and staff safety taking precedence
There were indications of a high level of risk aversion in the units visited,
resulting in staff safety taking too much precedence over patients’ and
prisoners’ comfort and rights. There appeared to be greater focus on control of
individuals than on their treatment, and an anticipation of disruptive behaviour,
especially in the case of a number of longer term mental health patients whose
behaviours were perceived as wilful rather than distressed. In one or two
cases, the management of patients appeared to have a punitive element.44
Though some staff concerns over their own safety were of course legitimate,
these needed to be considered and weighed against the individual’s needs and
wellbeing, and solitary confinement must not be continued indefinitely.
Blanket restrictive policies applied
A number of standard procedures and practices which applied to all those
segregated or secluded appeared unnecessarily restrictive and, when applied to
those who did not require them for health or safety reasons, also unnecessarily
punitive. Examples included: requiring all At Risk prisoners to wear strip gowns
43
A mechanism to limit the number of time a prisoner could flush their toilet appeared to be the norm in the
prisons visited for this review. I should note that I have not encountered a similar mechanism in any of the
many solitary confinement units I have visited over the years, including those in the so-called ‘supermax’
prisons in the US. Instead, most prisons have a mechanism which allows them to turn off the water supply
to cells if prisoners attempt to flood their cells.
44 In some cases extreme risk aversion led to what can only be described as excessively punitive treatment,
for example the management plan for one young woman who was a prolific self harmer, made use of her
hearing aid and access to family visits dependent on her behaviour and compliance. We were told that this
is because, in the past, she swallowed the batteries from her hearing aid, but this effectively meant that
her disability was used as a tool, and we were not clear how, with two to three members of staff with her
at all times, such action was practically possible.
47