facilities. MHAIDS, for example, have dedicated and enthusiastic local teams to lead seclusion reduction efforts and monitor its use. However, the length of time it took the Ministry of Health (MoH) to produce very basic data on the extent of the use of seclusion, the duration of seclusion events and the key characteristics of those secluded, indicates that much work is yet to be done. This review’s ability to assess the use of seclusion and restraint across health and disability facilities was limited by lack of timely access to national information and data from the Ministry of Health. Doubtless, this was in part because of COVID-19, which had meant that MoH personnel were under particular pressure, and everything else had to take a back seat. However, we were unable to obtain information from the Ministry despite repeated requests, also long after the initial lockdown period had ended. It took five months, from March to August, to receive any information, and then the information received was partial. I believe that the difficulty in obtaining information from the MoH was also at least in part due to difficulty in gathering the relevant information – which was worrying in itself, as good data keeping is key to any successful change. Other bodies have also noted the serious shortcoming associated with data collection and analysis by the Ministry, so the problem would appear to be a wider one. When we finally received the Ministry’s response to our request for data and information on changes and developments since 2017, it stated that: “Clinicians must record the duration and circumstances of each episode of seclusion in a register that must be available for district inspectors to review…. Seclusion must be reported to the Ministry of Health via a national mental health and addiction database (‘PRIMHD’). Statistics on the use of seclusion are published annually by the Ministry of Health in the Office of the Director of Mental Health Annual Reports. All reports are available online.” Whilst all this is true, of course, this response overlooks the difficulties cited as reasons for the inability to provide this review with the basic data on the use of seclusion, and the fact that – at the time of writing (November 2020), the latest report published by the MoH was the 2017 annual report, published as late as February 2019. The MoH noted that part of the problem lies with the different definitions and measurements used by the DHBs. Considering the immense investment in strategies to eliminate the use of seclusion, it would appear reasonable for a standardised definition and measurements to be in place by now.10 39