The mental health and addiction sector is aware that the goal we have set of eliminating seclusion is ambitious.
Internationally there is evidence that seclusion causes harm to those who receive it, and it is recognised as contravening basic human rights. Yet we know the practice still continues in many of our district health board in-patient units today.
Eliminating seclusion altogether will mean challenging ourselves, and each other, to change the way we think and act.
The good news is we are already part-way there; there have been huge advances in this area over the last nine years thanks to the work of Te Pou o te Whakaaro Nui, the National KPI group and front-line staff, and we acknowledge the ongoing efforts by many staff to keep on reducing restrictive care.
The national collaborative will enable us to step up our efforts and give us the continued, co-ordinated focus needed to sustain the gains made to date and accelerate towards the ambitious goal of eliminating seclusion. This process will take time and commitment and will challenge us to work better as a team. It will mean all health staff: nursing, allied and medical staff, playing a role in planning care so that instead of using seclusion, staff can implement other, effective strategies every time.
Consumers, the peer workforce and families/whānau also have an important role within the team. If we don’t hear what consumers say to us about seclusion, we are at risk of de-sensitising ourselves to the trauma it can cause. Therefore, we must keep the consumer voice central in this work and remind ourselves regularly of why we are making this change.
That’s why events such as the forthcoming co-design master classes are so important in helping staff at all levels to engage with consumers and their families/whānau meaningfully, so their experiences can inform us as we work towards this aspirational but achievable goal.
Everyone plays a vital part in the whole-of-system approach needed to successfully eliminate seclusion in our wider services. Fundamentally, it’s about team work. This is more than just nice words and warm feelings, it’s an approach which is critical to our future success and progress within our sector.
Author: Clive Bensemann, Clinical Lead, Mental Health and Addiction Quality improvement programme.