Seclusion is meant to only be used when necessary for the care or treatment of the service user, or for the protection of other service users. However, one of the issues highlighted in TOTB was that seclusion rooms were not always used for their intended purposes, but instead were used as overflow bedrooms when the wards / units were over capacity, or as longer-term housing for individuals who are perceived as high need or challenging. Reports by monitoring bodies indicate that seclusion rooms continue to be used, alongside other rooms and areas, for purposes outside their designation, in a practice described by unit staff as ‘sleep overs’. Reporting on so-called ‘sleep overs’ in one forensic inpatient ward, the Ombudsman stated that he considers these to be in breach of Article 16 of the UN Convention Against Torture (the prohibition against torture and inhuman or degrading treatment). I concur and join the Ombudsman’s call for such practices to cease. It was illuminating that the New Zealand Nurses Organisation Mental Health Nurse Section (MHNS) National Committee felt compelled to issue a public statement issued by the New Zealand Nurses Organisation Mental Health Nurse Section (MHNS) National Committee in response to critical reports by the Ombudsman, hinting at some of the complexities around seclusion reduction policies: “Seclusion rooms have been used as accommodation because of over occupancy and over-crowding. Mental health nurses make difficult choices every day in terms of either admitting service users when units are over capacity or declining them, which may result in unsafe conditions in the community. Mental health staff are criticised when they discharge service users too soon and criticised when they do not create space for service users in acute need. Mental health nurses have been concerned about staffing levels – both in numbers and levels of expertise. Mental health nurses have been concerned about violence and the provision of sufficient well-trained staff, in-patient and community facilities with safe environments to appropriately respond to challenging and complex situations. They have been asking for provision of safe environments conducive to delivering safe and therapeutic care. Mental health nurses have been concerned about access to acute services, the lack of acute care beds and the resourcing of services for people with high and complex needs and people presenting with co-existing serious mental illness and substance disorders – especially methamphetamine and alcohol. There is no flexibility in the 43