Kia ora and welcome to this monthly update from the mental health and addiction (MHA) quality improvement programme | Whakapai i ngā mahi hauora hinengaro waranga hoki. Highlights for this month include the release of two powerful videos on consumers’ experiences of seclusion, and two well-attended and energising regional away-days for Zero seclusion project teams.
In this update:
- Focus on Zero seclusion
- Addressing implicit bias e-learning resource
- In brief: Connecting care; Learning from adverse events and consumer, family and whānau experience
Focus on Zero seclusion
The focus on re-energising efforts towards eliminating seclusion in New Zealand continues, with a particular focus on reducing seclusion rates for Māori and Pacific consumers.
Consumers’ experience of seclusion
We are privileged to be able to share videos of two consumers’ experiences of seclusion. These are the first two in a series of at least six videos about MHA priority areas. Our sincere thanks to Jenny Fenwick and Haki Davis for sharing their stories.
Jenny, who works as a consumer advisor at Nelson Marlborough district health board (DHB), and Haki, who is a member of Te Kete Pounamu, both have experience of being secluded when in in-patient services. In the videos, they tell how their experiences have affected them and what alternative actions they believe staff could have taken.
The videos are a ‘must see’ for anyone working in MHA services, and for those in the wider health sector, as we focus on eliminating seclusion in New Zealand.
DHBs successful at reducing seclusion
We are also pleased to share the experiences of six DHB clinicians that have successfully reduced seclusion in their MHA services. Approaches showing promise include: improving admission processes, engaging differently with the individual and their family and whānau, greater use of cultural support, peer support, sensory modulation and other de-escalation approaches.
- Zero seclusion case study: How DHBs are successfully reducing the use of seclusion
- New Zealand hospitals reduce the use of seclusion for mental health consumers
Ten top tips from zero seclusion champions
- Provide kai and a welcoming environment
- Provide a quiet, low-stimulus space
- Listen to consumers' concerns and needs - learn what has happened to them
- Find out what people's triggers are
- Ensure consumers understand the admissions process - no surprises
- Involve whānau early on and throughout. When possible, let whānau stay with their loved one
- Empower staff with alternatives to seclusion
- Identify staff willing to pick up the zero seclusion mantle and work with them
- Set your team a 'no seclusion' goal and celebrate when it is achieved
- Spend time looking at your seclusion data and identify patterns when seclusions occur
Two supra-regional away days, focusing on Zero seclusion, were held on 24 November (for the Northern and Midland regions), and 26 November (for the Central and South Island regions). The away days gave DHB project teams an opportunity to come together in person to meet with the national MHA quality improvement team and share ideas.
The workshops were full of energy and ideas, with a strong commitment from attendees to reduce and eliminate seclusion.
Addressing implicit bias e-learning resource
An online learning resource on addressing implicit bias is being developed by the MHA quality improvement programme, in partnership with Capital & Coast DHB. A project design group made up of six DHBs is meeting fortnightly.
The purpose of the resource is to raise the awareness of implicit biases and practices in the MHA sector with a broader goal to reduce seclusion and other restrictive practices. It is currently being tested by the Mental Health, Addictions and Intellectual Disability Service, and Waitematā and Auckland DHBs.
All DHBs are encouraged to use the resource once it is more widely available, which is expected to be early next year.
- The final learning sessions for the Connecting care project were held on 21 and 22 October by Zoom. Following the learning session, project teams were invited to complete a survey monkey about their Connecting care projects and readiness to complete/close their project and any ongoing support required from the national MHA quality improvement programme team. Survey responses are being analysed and a project report will be produced.
- Learning session four for the Learning from adverse events and consumer, family and whānau experience project was held on 4 and 5 November. DHB project teams presented on their progress and their readiness to complete their project, as this is likely the final learning session for this priority area.
Te tautoko i a koe i tō haerenga whakapiki kounga
Supporting you on your quality improvement journey.