No benefit in seclusion of mental health patients, says Ombudsman
Chief Ombudsman Peter Boshier says he is worried about high rates of seclusion at two Bay of Plenty mental health facilities, particularly for Māori patients.
Mr Boshier today published reports of follow-up visits to Te Toki Maurere in Whakatāne and Te Whare Maiangiangi in Tauranga in July and August last year. Both are mental health inpatient units run by Bay of Plenty District Health Board.
Concerns around seclusion practices were reported for both facilities.
“My views on the use of seclusion are well-documented but I reiterate that I consider seclusion is a serious intervention with no therapeutic benefit and potentially harmful effects on patients,” Mr Boshier says.
“It concerns me greatly that reducing and eliminating its use seems to be making only slow progress, despite my regular calls for it to be stopped.”
Although a project team has been established at Te Whare Maiangiangi to reduce high and increasing levels of seclusion at the facility since the Ombudsman’s last inspection in 2018, Mr Boshier says progress has been slow.
The 2021 inspection found the number of seclusion events at the Tauranga facility had increased since the last inspection, from 59 events in six months, to 85 events. The number of hours spent in seclusion had, however, dropped, from 1413 to 833, which Mr Boshier acknowledges.
BOP DHB’s Reducing Seclusion project team had also acknowledged that Māori were still overrepresented in seclusion data, a fact Mr Boshier also highlights in his report of Te Whare Maiangiangi.
“I have made a recommendation in my report that Te Whare Maiangiangi addresses its high use of seclusion, particularly as it relates to Māori,” he says.
Mr Boshier has previously raised similar concerns about the disproportionate seclusion of Māori patients in a report about Te Awhina acute mental health unit in Whanganui.
“This should simply should not be happening. There is absolutely no reason for Māori patients to be secluded more than any others. I urge the Ministry of Health to address this as a matter of urgency.”
The inspection of Te Toki Maurere unit in Whakatane also showed an increase in seclusion events, from 26 in six months in 2018 to 39 over six months in 2021. However, data showed seclusion was generally reducing over time.
Mr Boshier has recommended that the unit improves data-recording systems to ensure the collection and reporting of reliable and accurate seclusion information. It follows a discrepancy found between the unit’s data and the DHB’s on the number of patients there and the number of hours they spent in seclusion.
“Reliable and accurate data is essential to ensure that the unit continues its progress towards reducing and eliminating the use of seclusion,” Mr Boshier says.
The inspections were carried out under the Crimes of Torture Act 1989. New Zealand is a signatory to the Optional Protocol to the Convention against Torture (OPCAT), an international human rights agreement.
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New Zealand ratified the United Nations’ Optional Protocol to the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment (OPCAT) in 2007. The Protocol requires states to establish independent National Preventive Mechanisms (NPMs) to regularly inspect places of detention and report on the treatment and conditions of those held within them.
The Chief Ombudsman was originally designated as a National Preventive Mechanism under OPCAT in 2007 which means he monitors places of detention designated to him, such as health and disability facilities, to prevent torture and other cruel, inhuman or degrading treatment or punishment.
He can recommend practical improvements to address any risks, poor practices, or systemic problems that could result in a service-user being treated badly. Follow-up inspections are conducted to look for progress in implementing previous recommendations. Reports are written on what is observed at the time of inspection.
Find out more about the Chief Ombudsman’s role in examining and monitoring places of detention, and read our other OPCAT reports, at www.ombudsman.parliament.nz