Contents Executive Summary 9 Acknowledgments 13 1. Seclusion and restraint: background, definitions, human rights standards and key principles for assessing their use 2. 15 a. Background 15 b. Definitions 16 c. Seclusion and restraint: health effects and human rights standards 17 d. Key principles for the use of seclusion and instruments of restraint 22 Seclusion and restraint in New Zealand: findings from the data and visits 24 a. The prevalence of the use of seclusion and restraint in New Zealand 25 b. The use of seclusion and restraints: concerns by institution type 30 Prisons 30 Health and disability units 36 Children and Young Persons’ Care and Protection residences and Youth Justice residences 38 Police custody suites 40 c.  The use of seclusion and restraint in New Zealand: common issues and concerns 42 d. Good practice examples 50 3. Recommendations 56 To all detaining agencies 57 To the Ministry of Health /District Health Boards 59 To the Department of Corrections 61 To the Ministry of Social Development (Child, Youth and Family) 62 To the police 63 To the NPMs 64 Appendix 1: Facilities visited 66 Appendix 2: International human rights law on solitary confinement and restraint 67 Appendix 3: The legal and administrative framework for the use of seclusion, segregation and restraint in New Zealand 77