Patients spend less time in locked rooms
Mental health patients in the Waikato are spending less time locked in a room to cool down after aggressive behaviour.
In some months, seclusion hours in adult mental health have more than halved compared to the previous year, Waikato DHB data shows.
The practice is a last resort when an agitated person is deemed a danger to themselves or others, and there was a marked drop in its use for Waikato adult mental health patients in 2020.
‘‘Nobody wants to seclude someone. Nobody thinks that’s a good idea,’’ director for clinical services for mental health and addictions Dr Rees Tapsell said.
‘‘We’re absolutely committed to the idea that people shouldn’t be secluded if there’s any other way.’’
The use of seclusion has been criticised by the United Nations and there’s a national push to end its use.
Waikato made changes from December 2019, which include adding a whakatau (welcome) on admission, debriefs when seclusion is used, and considering an approach accounting for trauma people have suffered.
Monthly seclusion hour totals for adult mental health in 2019 and 2020 show several drastic drops, and only one month of 2020 during which patients spent noticeably more time in seclusion.
The biggest drop was from the July
2019 peak of 1570 hours of seclusion to
371 hours in July 2020.
In contrast, forensic mental health – concerning those who have offended or are assessed as high risk – started the year with more seclusion use, but had drops later in the year.
Waikato doesn’t have the lowest seclusion rates, services director for mental health and addictions Vicki Aitken said, but it’s improving against previous performance.
‘‘Our seclusion level is too high,’’ Tapsell said, ‘‘but we’re trying really hard to reduce that every single day.’’
There’s a balance between reducing seclusion and protecting staffers and others, when it’s not uncommon to be verbally abused or more.
‘‘Two days ago one of our senior medical officers was assaulted,’’ Tapsell said when speaking to
October 2020 was the only month that year not to have similar or lower numbers of seclusion in adult mental health – instead having 251 more hours.
That was a difficult month, Aitken said, with people suffering methamphetamine withdrawals, many people in the centre – often with high needs – and lots of admissions and discharges.
Waikato is hamstrung by its overcrowded Henry Rongomau Bennett Centre.
‘‘Some units have the capacity to remove somebody from the general company of lots of others in a way that doesn’t mean they’re locked in a room without immediate egress and no other person in the room,’’ Tapsell said. ‘‘We don’t.’’
Government funding of $100 million has been committed to rebuild the centre.
In the meantime, the DHB’s ramped up its welcome, as arrival at hospital can be a flashpoint for seclusion – especially if those arriving come against their will, with police.