Seclusion and restraint still exist in Victoria’s mental health system

A scathing report from the Victorian Mental Illness Awareness Council (VMIAC) has found that the “abhorrent” use of seclusion and restraint continues to exist within the state’s mental health services.

Seclusion and restraint still exist in Victoria's mental health system

The controversial restrictive practices of restraint (using physical, mechanical, corporal, chemical, or physiological bonds to immobilize someone) and seclusion (locking someone in a room or confined space from which they cannot leave) are regulated in the Mental Health Act 2014.

But they should only be used “after all reasonable and less restrictive options have been tried or considered”.

A royal commission for Victoria’s Mental Health System, filed in March 2021, advised the state government to “act immediately” to reduce the use of seclusion and restraint in mental health, to eliminate it within ten years.

The government also has had a framework since 2013 to reduce restrictive practices, called “essential” for providing safe mental health care.

Camera icon The use of seclusion and restraint is still common in Victoria’s mental health system. Credit provided: News Regional Media

But VMIAC’s third annual Seclusion Report found that 27.75 percent of patients experienced restrictive practices last year.

The findings, released Wednesday, revealed 7,461 episodes of seclusion or restraint out of the 26,884 admissions to Victoria’s inpatient mental health facility in 2020-2021.

Sunshine Hospital (20.7), Box Hill Hospital (4.6), and St. Vincents Hospital (20.4) had the worst rates of isolation, mechanical isolation, and physical restraint for adult inpatient units, respectively.

Werribee Hospital (3.8), Geelong Hospital (2.0), and Bending Hospital (8.6) also saw the largest increases in those respective restrictive practices.

Camera IconBox Hill Hospital had the worst degree of mechanical isolation. NCA NewsWire/Ian Currie Credit: News Corp Australia

People who identified as Aboriginal and Torres Strait Islander were also more likely to be sequestered and detained than others.

ATIS people made up 3.5 percent of all inpatients but 5.3 percent of all isolations.

Country of birth was also associated with how likely people would be sequestered or restrained.

There have been longstanding concerns about the mental and physical consequences of seclusion and restraint, with fears that it could lead to harmful feelings, serious bodily harm, and even death.

Anonymous comments from consumers in the report testified to the potentially harmful effects of the restrictive practices.

“Isolation and restraint have been incredibly counterproductive and harmful to me. I think they could have been avoided if the environment had been calming, if I hadn’t been left alone and if a compassionate practitioner had built a rapport with me,” said an anonymous consumer submission.

“The use of restrictive interventions has been linked to re-traumatization of past experiences, serious injuries, and even death,” said another.

VMIAC chief executive Craig Wallace said the “gloomy” report was “painful” to read.

“The Seclusion Report is a dismal but incredibly important task for VMIAC and makes for painful reading. Like the CEOs before me, I look forward to the day when we no longer have to report so many traumas and serious human rights violations,” he said.

Camera IconVMIAC chief executive Craig Wallace said the report was “painful” to read. Delivered Credit: Delivered

“This year’s Seclusion Report emphasizes again that Victoria is lagging behind Australia in its use of seclusion and restraint.”

While consumers welcomed the royal commission’s recommendation to ban restrictive practices, Mr. Wallace feared the 10-year timeframe was too far off.

“Consumers have told us they are encouraged that the Royal Commission has recommended in Victoria’s Mental Health System to eliminate seclusion and restraint,” said Mr. Wallace.

“This policy need has been around for a long time; however, we are concerned about the too-long 10-year time frame.

“It’s unbearable to imagine the tens of thousands more preventable traumas that will happen if Victoria doesn’t move faster.”

Lori J. Kile
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