Tag Archives: seclusion

One Small Step for Mental Health Consumers

By Eileen McAtee

The Working Group expresses its concern relating to the widespread practice of seclusion in psychiatric units. While recognizing the Government’s achievement in reducing the incidents of seclusion since 2009, the Working Group urges the authorities to eliminate this practice.

(From the United Nations Working group on Arbitrary Detention Statement at the conclusion of its visit to New Zealand 24 March –7 April 2014)

By Eileen McAteeThe United Nations Working Group on Arbitrary Detention has been in New Zealand for three weeks visiting places of detention around New Zealand and meeting with representatives from the Human Rights Commission, the legal profession , academics and representatives of civil society organisations.

End Seclusion Now a lobby group calling for an immediate end to the practice of solitary confinement (or seclusion) in our hospitals made a submission to the Working Group on Arbitrary Detention. The submission asked the Working Group to strongly denounce the practice of seclusion in mental health facilities in New Zealand, to call for legislative change and to restore the right of individuals to have their complex and challenging responses to their life situations responded to in a way that does not cause further trauma. Members  of End Seclusion Now, who are able to personally  testify to the trauma caused by the practice of seclusion,  also  met  with  a member of the Working Groups Secretariat from the Office of the United Nations High Commissioner for Human Rights. 

The Secluded Individual Bullseye Diagram, developed by Anne Helm,  expresses the impacts of the practice on the secluded person. It addresses the four dimensions of the person as set out in Te Whare Tapa Whā written about by Dr Mason Durie. Seclusion negatively affects these interrelated dimensions, Taha Tinana (physical health), Taha Hinengaro (psychological health), Taha Wairua (spiritual health) and Taha Whanau (family health).

The United Nations Working Group  will present their full report  and recommendations to the NZ government  towards the end of the year.



Seclusion — what part do we all play?

By Eileen McAtee

Seclusion, forcibly confining or restraining a person in isolation in a room that is  barely furnished,   in mental health services has been in the media spotlight this week, following publicity about a young man  who has been in seclusion 23 hours a day for the past 3 years. See article in the Dominion Post and  this interview with  his father on National Radio.  It is hard to fathom how this situation can have continued for so long, or the degree of  trauma he has experienced over that time.

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Further coverage of seclusion followed the release of the Annual Report from the Office of the Director of Mental Health which reports, among other things,  on rates of seclusion by age , gender and District Health Board *. The report reveals that more than 1000  patients spent a total of 60,000 hours locked in seclusion last year.  As far as I can make out the seclusion statistics for Regional Rehabilitation Services, where the young man has been in continuous solitary confinement were not reported.  What the report does show is that  Māori are twice as likely to be secluded as non Māori. Te Runanga o Kirikiriroa in Waikato suggested this is because  some staff have a preconceived idea that Māori patients could be aggressive. The report also revealed seclusion rates at  Southern DHB  are  3 times the national average.

It seems timely to release the Kites Position paper on the Use of Seclusion in Mental Health Treatment Facilities in New Zealand . In a nutshell we assert that the use of seclusion be eliminated from all psychiatric facilities for the following reasons:

  1. It is a violation of human rights
  2. It is traumatising for all involved and especially for the person being secluded. This trauma can have serious negative effects for many years
  3. It can seriously damage any trust people may have in mental health services and diminish the likelihood they will seek treatment from them in the future.

The bigger picture is that we all have a role to play if the practice of seclusion is to be eliminated . If we, as a society, demand that people are “cared for”  to keep us safe, we end up with a risk adverse mental health system , and in some situations extreme inhumanity and cruelty to our fellow citizens .

Mental health services are in a conflicted  situation because the attitudes of and beliefs of many in our communities is that people who are mentally ill are dangerous and unpredictable, and need to be cared for within psychiatric facilities away from the public. This forces treatment facilities to become places of containment and social control and not places of compassion and healing.

If we are to eliminate seclusion from mental health services then all of us need to challenge our beliefs about mental distress and be open to alternative ways of supporting people. This paper provides some ideas about alternative ways of thinking and the  Like Minds, Like Mine Programme  is a  positive step in challenging our attitudes.

The video below,  Opening Doors developed by Awareness: Canterbury Action on Mental Health and Addictions delivers  a powerful message about  the impact of seclusion on all those involved.

* Also concerning in the report is the continuing rise in the number of compulsory treatment orders but that will have to be the subject of another blog .

Seclusion and the Health and Disability Standards

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. Continue reading Seclusion and the Health and Disability Standards