the regulation of seclusion and restraint and human rights – where to from here? a national mental...
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The Regulation of Seclusion and Restraint and Human Rights – Where to From Here?A National Mental Health Commission initiative in collaboration with the University of Melbourne
ANZAPPL Conference
Adelaide, 30 November 2013
Seclusion
the deliberate confinement of a person, alone, in a room
or area that the patient cannot freely exit
Seclusion
Restraint
• Physical: means bodily force that controls a person’s freedom of movement
• Chemical: means medication given primarily to control a person’s behaviour, not to treat a mental illness or physical condition
• Mechanical: means a device that controls a person’s freedom of movement
Definitions from Tasmanian Mental Health Act 2013
NMHCCF Definitions
Emotional restraint “occurs when the individual consumer is conditioned to such an extent that there is a loss of confidence in being able to express their views openly and honestly to clinical staff for fear of the consequences”
International Trends
UN Special Rapporteur on Torture has called for "an absolute ban on…restraint and solitary confinement of people with psychological or intellectual disabilities…in all places of deprivation of liberty, including in psychiatric and social care institutions”.
Juan E. Méndez
Legislative Provisions
National Guidelines
(NMHSR Project)
Codes of Practice or Policy Directives
A Combination of the Above
Outright Ban
Alternatives for Regulation
Current Laws
Most Australian mental health acts contain restrictions on the use of seclusion and mechanical restraints (New South Wales has guidelines).
The Tasmanian Mental Health Act 2013 and the New South Wales guidelines refer to physical and chemical restraint. The South Australian Mental Health Act 2009 has a principle that “medication should be used only for therapeutic or safety reasons”.
None refer to emotional restraint.
Current Laws
National Mental Health Commission
One of its ten
recommendations
targets reducing “the
use of involuntary
practices and work to
eliminate seclusion
and restraint”
Prof. Bernadette McSherry
Dr Annegret Kaempf
Assoc. Prof. Janet Clinton
Kay WilsonDr Bridget Hamilton
Cath RoperPiers Gooding
Assoc. Prof. Stuart Kinner
The Project Team
Dr Lisa BrophyAssoc. Prof. Carol Harvey
Advisory Groups & Focus Groups• People with Lived Experience
Advisory Group
(5 members)
• Families and Supporters Advisory
Group
(5 members)
Advisory Groups
Project Plan
Main aim of the projectFind evidence of “best practice” in reducing and/or eliminating seclusion and restraintMixed methods approach
Online surveysCall for evidenceFocus Groups
Target groupsconsumers, families and supportersindigenous populationservice providers“first responders”prisoners
Aim and Approach
The Literature
• Changes to the physical
environment
• Organisational change
• Alternative techniques for
managing aggression
Challenges
• Definitions• Survey dataensuring sufficient sample size for various target groupsclearly directed questionsidentification of common issuesevidence and dimensions of surveys• Best delivery of resultswell-considered presentation of data/best practice in a final reportreader-friendly and practice focused
Challenges
© Copyright The University of Melbourne 2011
http://www.socialequity.unimelb.edu.au/seclusion-and-restraint/