Another DHB highlighted the very low use of seclusion in its forensic units and
the decommissioning of two seclusion rooms since the original report. It too
highlighted its engagement in the Zero Seclusion Project and the forthcoming
creation of a Reducing and Preventing the Use of Restrictive Practices Group to
share learning and support improvement, underpinned by a policy document.
The DHB noted that funding had now been approved for the re-build of one of
the units, further improving the quality of accommodation. They emphasised
that all seclusion rooms are designed for that purpose, with call bells available
to all service users, though noted that in most cases service users do not have
control over lighting or temperature.
Finally, it noted the co-design approach they had taken within the Zero
Seclusion Project, seeking to involve staff, service users and their whanau
(though unsuccessfully with this latter group), and pointed to a regular interagency meeting, including the police and emergency staff, to support the
greater cross-sector collaboration which I recommended in TOTB.
In its submission to this review one Civil Society Organisation similarly pointed
to the Government’s commitment to repeal and review the Mental Health Act,
consultation on updated Guidelines to the Act, and the Health Quality and
Safety Commission’s quality and improvement programme to reduce seclusion
and restraint, as positive developments. It also noted, however, the importance
of a establishing a clear legislative timetable; that aspirations for zero seclusion
needed to have real weight behind them to drive change and; that there was still
much work to be done, particularly for Mäori. It noted that whilst section 7.1 of
the Ministry’s seclusion guidance had been amended, as recommended in TOTB,
section 7.2 remained unchanged.
Another Civil Society Organisation expressed concern that despite positive
intentions to eliminate seclusion, its use was again increasing, whilst noting a
lack of consistency in the recording and reporting of data. Other submissions
re-iterated these concerns and the goal of zero seclusion was in practice
dependent on legislative change subject to an uncertain timescale.
The current use of seclusion in health and disability
facilities: key findings
One of the key recommendations made in TOTB was for data on the use of
seclusion to be more fully recorded and analysed. Since the original review
took place, some good protocols on data collection and analysis developed as
part of the wider project to reduce the use of seclusion in health and disability
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