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Review of seclusion, restraint and observation of consumers with a mental illness in NSW health facilities

Review of seclusion, restraint and observation of consumers with a mental illness in NSW health facilities

The National Mental Health Commission welcomes the release of the report on the Review of seclusion, restraint and observation of consumers with a mental illness in NSW Health facilities and the commitment by the NSW government to accept all 19 recommendations and provide $20 million to help hospital managers improve the therapeutic environment inside acute mental health units.

The Commission’s CEO, Dr Peggy Brown said it is tragic that it took the death of Miriam Merten in a Lismore facility to achieve this independent scrutiny on the restrictive practice in the NSW health system.

"The National Mental Health Commission calls for each jurisdiction in Australia to review their use of restrictive practices and increase their effort towards eliminating the use of seclusion and restraint," Dr Brown said.

“As part of the Commission’s role to nationally monitor and report on the health system, we will contribute to a national approach to improve transparency in reporting seclusion and restraint data across jurisdictions and services. 

“However, there needs to be jurisdictional agreement on which health settings are to be monitored as the NSW Review highlights the need to include reporting on practices in emergency departments.’’

Dr Brown said everyone in a mental health service has a right to receive safe and contemporary care and to be treated with dignity and respect. This means that best practice standards and guidelines on reducing restrictive practices must be adopted across the nation.

Recently, the Commission worked with the Australian College of Mental Health Nurses to research the factors that impact on the decisions of frontline workers such as mental health nurses to use seclusion and restraint. The findings indicated that despite best practice techniques being available to reduce or eliminate seclusion and restraint, national system-wide implementation is inconsistent.

The Commission will continue to advocate for ongoing reform in this area and while keenly observing NSW’s progress in response to the Review, will be looking to stimulate national action on strategies to reduce restrictive practices early in 2018.

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Acknowledgement of Country

The Commission acknowledges the traditional custodians of the lands throughout Australia.
We pay our respects to their clans, and to the elders, past present and emerging, and acknowledge their continuing connection to land, sea and community.


The Commission is committed to embracing diversity and eliminating all forms of discrimination in the provision of health services. The Commission welcomes all people irrespective of ethnicity, lifestyle choice, faith, sexual orientation and gender identity.

Lived Experience

We acknowledge the individual and collective contributions of those with a lived and living experience of mental ill-health and suicide, and those who love, have loved and care for them. Each person’s journey is unique and a valued contribution to Australia’s commitment to mental health suicide prevention systems reform.