The Health Quality & Safety Commission says the recently released annual report of the Office of the Director of Mental Health and Addiction Services highlights once again the urgent need to eliminate the harmful practice of seclusion of mental health services consumers.
The Commission has a project specifically focused on eliminating seclusion in New Zealand, Zero seclusion: Safety and dignity for all | Aukatia te noho punanga: Noho haumanu, tū rangatira mō te tokomaha. The project is part of a wider mental health and addiction programme, funded by DHBs.
Seclusion is the practice of placing a mental health consumer in a room from which they can not freely exit. Programme clinical lead Dr Clive Bensemann says seclusion is traumatic and harmful for consumers, whānau, visitors and health workers, and needs to end.
‘There are many other ways of supporting people in distress which are safe and evidence-based. Making changes to seclusion rates is complex and takes time, however we believe zero seclusion is achievable – it is already being achieved by some services.’
The Commission’s zero seclusion project started in 2019 and gathered pace in 2020.
Dr Bensemann says data from November 2020 has signals of positive change.
‘There is a downward trend in national data for duration of seclusion in DHB mental health units, including for Māori and Pacific consumers. Ten DHBs have seen signals of improvement in a particular unit and indicator/population or have reached zero seclusion at times.’
He says the Commission is working collaboratively with the Ministry of Health, Te Pou and DHB project teams to further reduce, prevent and eliminate seclusion in ways that are sustainable, person-centred, safe for everyone and evidence based.
Approaches that are showing promise, and align with evidence from Te Pou, include engaging well with the individual and their family and whānau, cultural support, peer support, sensory modulation, and other de-escalation approaches.