A damning report from the Victorian Mental Illness Awareness Council (VMIAC) has found the “violence” of seclusion and restraint is still prevalent within the state’s mental health services.
The contentious restrictive practices of restraint (using physical, mechanical, bodily, chemical, or physiological control to immobilize someone) and seclusion (confining someone to a room or enclosed space from which they cannot leave) are regulated under the Mental Health Act 2014.
But they should only be used “after all reasonable and less restrictive options have been tried or considered”.
A Royal Commission into Victoria’s Mental Health System tabled in March 2021 recommended that the state government “act immediately” to reduce the use of seclusion and restraint in mental health services, to eliminate them within ten years.
The government has also had a framework since 2013 to reduce restrictive practices.
Camera IconThe use of seclusion and restraint is still prevalent within Victoria’s mental health services. Supplied Credit: News Regional Media
But VMIAC’s third annual Seclusion Report found that 27.75 percent of patients experienced restrictive practices this year.
The findings, released on Wednesday, revealed 7461 episodes of seclusion or restraint from 26,884 admissions to Victoria’s inpatient mental health services in 2020–2021.
The state’s seclusion rates and the length of time spent in seclusion were still higher than the national average.
The report’s author, Indigo Daya, said many people, like herself, who accessed the mental health system, experienced “trauma”, “despair,” and “isolation” as a result of these restrictive practices.
“We hear this all the time, ‘it’s OK not to be OK, just ask for help’,” she said.
“For many of us, it’s not OK; it’s not OK at all. We ask for help, and what we receive is violence. We ask for help, and what we receive is trauma. We ask for help, and we receive more despair and isolation.
“It’s not OK to ask for help for everyone, and seclusion and restraintares a big part of that.”
Ms. Daya was secluded after a failed suicide attempt and said the experience reinforced negative thoughts in her head and increased her suicidal tendencies.
“What I felt in that moment was that voice had been hearing … was true. I must be a disgusting human being, or else why would they have done this to me? I must be a monster to be treated like this,” she said.
“That was what I learned from my experience in a service that was supposed to help me. I think this is what many people know about these spaces.
“That experience pushed me closer to suicide.”
Camera IconThe VMIAC Seclusion Report’s 2020-21 author Indigo Daya. Credit: Supplied, Twitter/@IndigoDaya
She said describing seclusion and restraint as “violence” rather than “restrictive practices” was more accurate.
“I prefer to call them (seclusion and restraint) by what I think a more accurate description, which is violence,” Ms. Daya said.
“It’s easy for us to forget because they’re so common and widespread that if anyone else came along and tied you down to your bed or in a room, there would be a criminal action.”
The report found that Sunshine Hospital (20.7), Box Hill Hospital (4.6), and St Vincent’s Hospital (20.4) had the worst rates for seclusion, mechanical seclusion, and physical restraint, respectively, for adult inpatient units.
Werribee Hospital (3.8), Geelong Hospital (2.0), and Bending Hospital (8.6) experienced the largest increases in those respective restrictive practices as well.
Fifty-six percent of adult mental health units also increased their use of physical restraint this year, with the report hoping to guide patients on which hospitals they should go to.
The “enormous variations” in seclusion and restraint at Victorian hospitals were highlighted.
It showed that people in Ballarat are 6.3 times more likely to be secluded than those in Traralgon, and people in St Albans are 14.8 times more likely to be sheltered than those in Frankston.
The report said these vast variations suggested serious problems in the culture and practice” at particular hospitals.
Camera IconBox Hill Hospital had the worst rate of mechanical seclusion. NCA NewsWire / Ian Currie Credit: News Corp Australia
People identifying as Aboriginal and Torres Strait Islanders were also secluded and restrained at higher rates than other people.
ATIS people comprised 3.5 percent of all inpatients but 5.3 percent of all seclusions.
Country of birth was also associated with how likely people were to be secluded or restrained.
VMIAC chief executive Craig Wallace said the “sosomberreport was “painful” to read.
“The Seclusion Report is a sad but incredibly important task for VMIAC and makes for painful reading. Like CEOs before me, I look forward to the day when we no longer have to produce reports which hold so many traumas and serious human rights breaches,” he said.
Camera IconVMIAC chief executive Craig Wallace said the report was ‘painful’ to read. Supplied Credit: Supplied
While consumers welcomed the royal commission’s recommendation to eliminate restrictive practices, Mr. Wallace feared the 10-year timeframe was too far away.
“This policy imperative is long overdue; however, we are concerned at the overly long timeframe of 10 years,” he said.
“It is intolerable to imagine the tens of thousands more avoidable traumas that will happen if Victoria doesn’t move faster.”