Restraint and seclusion in mental health
Restraint and seclusion are interventions of last resort used when other options have failed to maintain safety for the person experiencing distress, staff or others. Restraint and seclusion are not therapeutic interventions.
The Restraint and Seclusion in Mental Health Services Policy Guideline (PDF 331KB) is based on the current best available evidence on the prevention and elimination of restraint and seclusion and the management of restraint and seclusion where it is used as a last resort. They are set in the context of early intervention measures to prevent restraint and seclusion occurring and promote the principle of least restrictive practice.
The Policy Guideline has an associated Toolkit which is comprised of eight fact sheets to assist with implementation. These are:
- Activity Programs for Mental Health Unit (PDF 110KB) - looks the rationale behind activity programs and the expectations of inpatient programs and the resourcing required. It also includes an Activity Sheet form for consumers.
- Agitation scales (PDF 136KB) - 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 (PDF 60KB) - how you can help consumers understand what is happening and what is being offered to them
- Personal Prevention Plan (PDF 76KB) - looks at the triggers to the person becoming agitated, symptoms of agitation and calming strategies. Includes the Personal Prevention Plan.
- Guide to review of restraint and seclusion (PDF 134KB) - ideas for senior clinicians to think about when scrutinising and reviewing seclusion
- Sensory modulation (PDF 58KB) - covers technique examples and therapeutic activity examples.
- Debriefing following and incident of restraint or seclusion (PDF 55KB) - The Crisis Prevention Institute COPING Model allows everyone an opportunity to debrief and discuss what occurred.
- Restraint and seclusion reporting (PDF 107KB) - 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.
Chief Psychiatrist Standards
The Office of the Chief Psychiatrist has developed the following standards in accordance with Section 90(2) and (3) of the Mental Health Act 2009.
- Restraint and Seclusion – Recording and Reporting (PDF 326KB) - outlines the requirements of health services to record information and make notifications to the Office of the Chief Psychiatrist, to enable the monitoring of the use of restraint and seclusion
- Restraint and Seclusion – Application and Observation Requirements (PDF 977KB) - outlines the requirements of health services to implement observation standards in relation to restraint and seclusion use, consistent with local, national and international best practice.