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Seclusion and Restraint Position Paper released

29 May 2015

Decisive action needed on commitments made ten years ago to reduce and eliminate the use of seclusion and restraint in mental health

The National Mental Health Commission will use its address at the 10th National Seclusion and Restraint Forum in Melbourne today to call for a nationally consistent approach to reporting on and reducing the use of seclusion and restraint.

Seclusion and restraint are interventions used in mental health facilities and other settings to control or manage a person’s behaviour. ‘Seclusion’ is when someone is isolated and confined in a specific room from which they cannot leave. ‘Restraint’ is when someone’s movements are restricted by another person or persons, or the use of straps or belts (physical or mechanical restraint) or sedation medication (chemical restraint).

Jackie Crowe, a Commissioner at the National Mental Health Commission will tell the forum: “All Australians have a right to safe and effective care, and to work in an environment that is safe and supportive.  

“While considerable work is underway around Australia to understand and address the factors that lead towards seclusion and restraint and to monitor its use, we believe that much more can and must be done.

“There is a lack of evidence internationally to support seclusion and restraint in mental health services. There is strong agreement that it is a human rights issue, that it has no therapeutic value, that it has resulted in emotional and physical harm, and that it can be a sign of a system under stress. 

“The Commission urges all Australian governments to support the commitment made in 2005 to reduce and where possible to eliminate the use of seclusion and restraint by giving priority to achieving:

  • jurisdictional agreement on definitions for seclusion, physical restraint, mechanical restraint and chemical restraint that is then reflected in jurisdictional legislation
  • targets and reporting frameworks that ensure that we have consistent, national data that give an accurate and meaningful account of what’s really going on
  • a national approach to the regulation of seclusion and restraint that includes:
    • standards and guidelines to support national consistency in approach to reducing the use of seclusion and restraint
    • inclusion of a standard specifically addressing restrictive interventions in the next revision of the National Safety and Quality Health Service Standards
    • national monitoring and reporting on seclusion and restraint across jurisdictions and services.

“In addition, we need research into the prevention and safe management of behavioural emergencies involving people experiencing mental health difficulties, in all settings. This research should consider people of all ages and include people with lived experience of mental health difficulties and family and carer perspectives so that opportunities to improve current outcomes and practices can be identified.

“Positive change needs leadership, but shared ownership across people with lived experience, their families and carers, advocacy groups, emergency departments and other health providers, schools, the justice sector and police and ambulance services is equally important. We’ve identified the things that can make the biggest difference most quickly.  Now it’s time to work together on getting those things done.”

"Even the most disadvantaged Australians should be able to lead a 'contributing life,' whatever that means for them and this simple goal will be our touchstone and yardstick."

Chair Prof Allan Fels AO
National Mental Health Commission

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