By Eileen McAtee
The Health and Disability Standards are under review. Health and disability services are audited under these standards. HealthCERT, a business group at the Ministry of Health, are doing this work and are currently requesting input via a survey process. It is a relatively short survey open until the 24th of May and I encourage as many people as possible to participate. The standards will not be up for review again for several years.
I thought I would share some of our thoughts here at Kites about the need for changes to one standard in particular: ‘Safe Seclusion Use’, in the Restraint Minimisation and Safe Practice Standards.
Given that we now have a national goal in New Zealand to eliminate the use of seclusion included in the Rising to the Challenge The Mental Health and Addiction Service Development Plan we believe the standard should be updated to support that goal.
The name of the standard itself: ‘Safe Seclusion Use’, is a contradiction in terms and obscures the harmful impact of this practice. A more honest term for the Standard would be ‘reducing the harmful effects of the use of seclusion’. If you want to learn more about the traumatic effects of seclusion on both the people who are secluded, and the staff, they are articulated beautifully in the documentary ‘Opening Doors’, produced by Awareness Canterbury.
Because of the evidence that seclusion can result in trauma, a requirement to provide an opportunity to debrief for the person secluded and staff may be useful. This would also allow for a discussion of how the use of seclusion can be avoided in future.
Strengthening the wording of the standard so it describes seclusion as a failure of all other options rather than implying that it is valid in certain circumstances would help discourage its use.
Our local District Health Board has started working towards a goal of eliminating seclusion, surely our national Health and Disability Standards should recognise, encourage and support that ?