Victorian psychiatrists call for reduction of seclusion

The Royal Australian and New Zealand College of Psychiatrists (RANZCP) Victorian Branch has reiterated support for stronger measures to reduce the use of seclusion and restraint in the Victorian mental health system.

This comes in response to the recent Victorian Mental Illness Awareness Council (VMIAC) report, finding that the state’s seclusion rates are higher than the national average.

The RANZCP Victorian Branch wants to see a reduction and wherever possible the elimination of the use of seclusion and restraint. This must be done in a way which supports good clinical practice and provides safe and improved care for consumers, explained Chair, Dr Kerryn Rubin.

‘Reducing, and where possible eliminating, the use of seclusion and restraint should be a priority for mental health services across Victoria’, said Dr Rubin.

‘Seclusion and restraint are experienced by consumers as emotionally unsafe and disempowering interventions, can be a very traumatic experience for people, and can be retraumatising for a people with a history of trauma.

‘We are seeing mental health services across Victoria implementing a range of innovative strategies to reduce the use of seclusion and restraint. With time, we would even hope to see the potential elimination of designated seclusion rooms in our future mental health system.

‘This will require leadership, commitment and motivation, and a change culture underpinned by recovery with a focus on workforce and training, prevention and early intervention, good clinical care and supporting practice change.

‘The variation in the use of seclusion and restraint across Victoria is concerning. All Victorians should expect the same quality of care no matter where they live. There are good opportunities for services with low rates of seclusion to share their knowledge and practices with services that are working on further reducing their rates of seclusion.’

There is good evidence that practice changes in managing people with a deteriorating mental state can lead to significant decreases in the use of seclusion and other restrictive practices.

Whilst the RANZCP acknowledges that there are situations where restraint and/or seclusion may be used as an appropriate safety measure of last resort, this should only be under the strictest protocols and where all other interventions have been tried or considered and excluded.

‘Reducing the use of seclusion and restraint requires commitment and leadership from the whole mental health sector to change existing practices’, added Dr Rubin.

‘As strong supporters of Supported Decision-Making, and recovery oriented care, the Victorian Branch of the RANZCP is strongly committed to an ongoing reduction in the use of restrictive interventions, including seclusion, across all mental health services.

‘We welcome the increased focus on reducing the use of seclusion as a further impetus for change’

‘For this to happen, we need continued and increased investment in the mental health sector in order to deliver the high-quality care that all Victorians deserve.’

Further detail can be found in the RANZCP Position Statement 61: Minimising the use of seclusion and restraint in people with mental illness.

ENQUIRIES: For more information, or to arrange an interview email media@ranzcp.org.

For all other expert mental health information, visit Your Health in Mind, the RANZCP’s consumer health information website.

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