Restraint and seclusion in mental health

Restraint and Seclusion Chief Psychiatrist Standard and Toolkit

The Chief Psychiatrist has developed a Chief Psychiatrist Standard: Reduce and Eliminate where possible the Use of Restraint and Seclusion applied under the Mental Health Act 2009.

The Standard applies to all those involved in the administration and operation of the Mental Health Act 2009 across public and private settings.

The use of restraint or seclusion has the potential to increase the risk of trauma and or trigger symptoms of past experiences of trauma. It is a last resort option only to maintain safety for all .

Compliance with the Standard is expected as of 01 July 2021 while comment and feedback on the implementation remains open. While this Standard is being implemented, services are expected to comply with existing Chief Psychiatrist standards and SA Health policies.

Any feedback about the Standard and implementation can be emailed to: Health.OCPSafetyQuality@sa.gov.au

The Standard is accompanied by the following Toolkit fact sheets and resources:

  • Activity Programs for Mental Health Unit - looks at the rationale behind activity programs and the expectations of inpatient programs and the resources required. It also includes an Activity Sheet form for consumers
  • Agitation Scales - explains what agitation scales are and how to complete Agitated Behaviour Scale (ABS) Rating form. It also includes the Agitated Behaviour Scale (ABS) Rating form
  • Effective Limit Setting - how you can help consumers understand what is happening and what is being offered to them
  • Comfort Plan - Looks at the triggers to a person becoming distressed, personalised signs and symptoms of their distress and strategies they find calming. The Comfort Tool is included and can be altered to accommodate specific consumer groups and available resources within individual service settings
  • Guide to Review of Restraint and Seclusion - ideas for senior clinicians to think about when scrutinising and reviewing seclusion
  • Sensory Modulation - covers technique examples and therapeutic activity examples
  • Trauma Informed Post Incident Conversation Guide - Is a guide to a post-incident conversation between staff, individuals and family members (where relevant) using trauma informed approaches. It can be used by staff or the lived experience workforce and is not limited to use after the occurrence of a restrictive practice incident but following any incident that has caused distress.
  • Restraint and Seclusion Reporting - covers mandatory reporting in the Safety Learning System (SLS), frequently asked questions and a step-by-step guide on how to report incidents. Includes Critical Incident Report Form notifying the Office of the Chief Psychiatrist on page 8
  • Approval of Mechanical Devices - includes an Application Form for approval of new devices. The approval and application is based on the requirements of the Chief Psychiatrist under the Mental Health Act 2009 s6 (a) (ii) to ensure that persons with a severe mental illness retain their freedom, rights, dignity and self-respect as far as is consistent with their protection, the protection of the public and the proper delivery of the services and at s90 (1) (b) to monitor the treatment of patients and the use of restrictive practices in relation to such patients.

With the release 1/2/21 of the Chief Psychiatrist Restraint and Seclusion Standard: Reduce and Eliminate Where Possible the use of Restraint and Seclusion applied under the Mental Health Act 2009; the following existing Policy and Standards will be superseded following complete implementation by 1 July 2021:

  • Restraint and Seclusion in Mental Health Services Policy Guideline (2015)
  • Chief Psychiatrist Standards; Restraint and Seclusion Recording and Reporting (2015) and Restraint and Seclusion Application and Observation (2015).

Visit the Office of the Chief Psychiatrist South Australia website for further information.