When I first started working in mental health inpatient services seclusion and restraint was embedded in practice culture. Staff spent hours learning techniques on restraint holds and how to safely ‘take someone down’.

Mental health has come a long way in the last twenty years, and compared internationally, New Zealand is doing well in leading recovery and values based practice for people who engage in services.

However, we are not there yet. Seclusion and restraint is still widely used throughout services in New Zealand. For Maori the rates of seclusion are unacceptably high. This can be due to a number of factors such as how someone enters a service, their history, the inpatient environment, staffing resources, staffing knowledge and clinical leadership, as well as times when there is just a series of unexpected issues that lead to an incident of restraint. Research in this area is critical.

As we see it, the best way we can influence the reduction of seclusion and restraint practice is by offering skills, tools and techniques to staff who work with service users, and service users themselves who can avoid getting into the situation of high arousal and distress.

We also want to shout from the rooftops about those who have shown leadership and tangible results by using alternatives to seclusion and restraint. We will continue to profile those who have lead the way.

We are pleased to see the reduction of seclusion remains a priority for the Ministry of Health and for services. We must continue to address areas where we should be doing better.

In coming months we will be looking to address work on Maori seclusion rates and how to better address training on de-escalation. I am hopeful this work can influence disability services in the near future too.