Thousand in seclusion is fewer than in the past

16:00, Nov 12 2013

More than 1000 mentally ill patients spent a total of 60,000 hours locked in seclusion last year, even as the Ministry of Health attempts to curb the practice.

While the number of people forcibly barred in rooms decreased by 9 per cent from 2011 to 2012, district health boards were still using the controversial technique. Wairarapa is the only board that does not use seclusion, because it has no mental health service.

Those locked up included 60 children and young people.

The figures are revealed in the annual report of mental health director John Crawshaw, and follow revelations that mentally ill Wellington man Ashley Peacock has remained in seclusion for more than three years.

Yesterday, Dr Crawshaw said seclusion rates had dropped yearly since the reduction policy was introduced in 2009 - a "significant move forward".

"While I would like to see further reduction, I think it's pleasing that we are starting to proceed down that pathway . . . I'm confident that we're headed in the right direction."

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He would be questioning DHBs with higher rates of seclusion, including Hutt Valley, Southern, Nelson-Marlborough and Northland. The Government's aim was to stop the use of seclusion - defined as forcibly confining or restraining a person in isolation in a room that is often kept barely furnished.

The report into the country's public mental health services also shows more New Zealanders are seeking specialist treatment - 148,000 last year, a number that has almost doubled since 2002.

And more people were subject to compulsory treatment orders under the Mental Health Act, with 4328 under court orders last year to get help.

Dr Crawshaw said the rise in specialist treatment was positive, as it showed more people had access to services.

The 2012 Rising to the Challenge mental health plan aimed to address the high use of compulsory treatment orders, by making sure problems were caught earlier, he said.

But Mental Health Foundation chief executive Judy Clements said change was intolerably slow.

"We've been concerned for years about the use of seclusion. We don't see it having a place. We shouldn't be locking people in windowless rooms in the 21st century.

"There needs to be a determined effort to get it done faster."

Compulsory treatment orders were equally antiquated, and should be used as an absolute last resort, she said. "It seems to be almost the norm."

Just one investigation under section 95 of the Mental Health Act was completed in 2012, into systemic issues at the Hutt Valley District Health Board.

This included the case of a woman who set herself on fire and cut her body repeatedly while an in-patient at Hutt Valley's mental health unit, before killing herself when she was released into the care of her family.

Hutt Valley DHB chief executive Graham Dyer said all the recommendations in this report had been implemented.

THE NUMBERS

6823 patients spent time in adult mental health units (excluding forensic and rehabilitation services).

This is an increase of 400 in the past six years.

61 people died while subject to the Mental Health (Compulsory Assessment and Treatment) Act: 20 by suicide, and 41 through illness or natural causes.

265 people received electroconvulsive therapy – an average of 10 sessions – a controversial treatment the Ministry of Health considers effective for some serious neuropsychiatric conditions. 

Fairfax Media