Many of the other issues identified in the 2017 review persist, including: risk averse policies and practices; impoverished regimes; austere material conditions and some un-fit for purpose accommodation; lack of individual autonomy; and over-reliance on staff availability and good will. My recommendations accordingly focus on the same key themes as in 2017: • Finding alternatives to Secure Rooms and similar separation practices for children and young people. • Reducing both the use and length of seclusion and restraint; • Exploring potential racial and gender bias in decision making on seclusion and segregation placements; • Improving material conditions and access to meaningful human contact and activities in seclusion/segregation; • Providing therapeutic environments for distressed individuals, and seeking alternatives to seclusion and restraint for them; • Decommissioning facilities which are not fit for purpose. Effective implementation of these recommendations must be underpinned by good quality and comprehensive data, which currently remains far too fragmented. The central message of this report, though, is that a significant shift in the very way that detaining agencies think about the extreme tools of seclusion and restraint, is needed. Only then will a meaningful change be possible to achieve. 9