123. In 2020, Time for a Paradigm Shift: A follow-up review of seclusion and restraint practices in Aotearoa New Zealand147 was published to provide a follow-up to the 2017 report. Positive developments included a national effort to reduce the use of seclusion and restraint in health and disability facilities; an end to the use of ‘tie down’ beds in prisons and; a greater commitment to Māori culture and values in the care of children and young people by Oranga Tamariki.148 124. However, the follow-up report indicated that while there had been positive developments and strong commitments from the detaining agencies to reduce the use of seclusion, it continues to be embedded in their practices. The overall picture was found to be disappointing with ongoing issues that had not been addressed, such as:149 (a) Seclusion continues to be used too often, for too long, and not always with clear justification. (b) The use of seclusion remained disproportionately high with Māori and Pacific Peoples across the board. (c) The data on the use of force and restraint was concerning. (d) Seclusion (or solitary confinement) continued to be disproportionality used with Māori and Pacific Peoples in Health and Disability facilities, in children and young people’s care and protection and justice residences (where the practice is known as ‘secure care’), and in prisons (where the practice is known as ‘segregation’). 125. 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. 126. In July 2019, Corrections established a new Prisoners of Extreme Risk Unit (PERU) to hold detainees identified as presenting an “extreme risk”.150 The role of the PERU has since been expanded, to cover prisoners who are identified as presenting an ongoing risk of serious violence” or having the ability to “influence others to engage in serious violence or threats.”151 It is understood that prisoners within this unit in seclusion and under constant observation. As of February 2022, there were ten prisoners held in PERU.152 127. Following the concerns identified in Time for a Paradigm Shift in relation to the use of solitary confinement and force against women in prison, particularly Māori women, in 2021 Dr Shalev 147 Dr Sharon Shalev, Time for a Paradigm Shift: A follow-up review of seclusion and restraint practices in Aotearoa New Zealand (2020) available at https://tikatangata.org.nz/our-work/time-for-a-paradigm-shift. 148 Ibid., summary at p. 8. 149 Ibid., summary at p. 8-9. 150 Blair Ensor and Sam Sherwood “Prisoners of ‘extreme risk’ directorate set up after Christchurch terror attach” Stuff NZ (16 November 2020) at https://www.stuff.co.nz/national/crime/123404448/prisoners-of-extreme-risk-directorateset-up-after-christchurch-terrorattack#:~:text=Managed%20by%20commissioner%20Jeanette%20Burns,staff%2C%20other%20prisoners%20or%20th emselves. 151 Carolyne Meng-Yee “Prison within a prison: Secret $3m unit to hold mosque shooter” NZ Herald (7 March 2021) at https://www.newstalkzb.co.nz/news/crime/christchurch-mosque-shooter-brenton-tarrant-and-two-dangerouscriminals-in-special-prison-within-a-prison/. 152 Otago Daily Times “Otago man in Extreme Risk Unit with mosque shooter” (15 February 2022) at https://www.nzherald.co.nz/nz/otago-man-in-extreme-risk-unit-with-mosqueshooter/PEGPIM67PUL77QPS6YMXB62PQY/. 31