Australia’s Public Mental Health System

Running head: MENTAL HEALTH 1
Mental health
Name
Institutional Affiliation

MENTAL HEALTH 2
RESTRICTIVE PRACTICES REDUCTION OF SERVICES FOR MENTAL HEALTH
IN AUSTRALIA
In recent years there have been movements by consumer groups in order for reduction of
restrictive practices in Australian services of mental healthcare. The possibility of the
movements is that the consumers' groups seek to challenge the mental health practitioners and
government enforcements that stigmatize mentally ill patients and weakens workers' interest.
Mental health services, unlike other healthcare services, are uniquely mandating coercion and
restriction practices to be part of the mental health services (Quinn et al., 2019). The common
coercive measures that are being utilized in Australia are physical restraints, seclusions and to
some extent mechanical restraints. All these forms of coercion and retraining predate the medical
discipline of psychiatry thus modernity. Seclusion is one of the most controversial practices in
delivery of services of contemporary mental health (Alaattinoğlu & Rubio-Marín, 2019). Despite
a call for elimination and reduction in restrain & seclusion in services of mental health, the
practices are still being used all over the mental health facilities. Seclusions is a strategy used in
most of the psychiatric hospitals to cope with aggressive mentally ill inpatients. Historically,
seclusion is one of the oldest approaches that is used to treat mentally ill patients. Aggression is
the primary rationale for using seclusion as a way of restrictive practice. In some psychiatric
settings, seclusion has been used as a form of punishment to the patients
Restrictive and coercive practices are used in mental facilities to protect the consumers
and healthcare professionals from mentally ill aggressive patients. In the ancient times, seclusion
was considered the last option as a mental health service to ensure the staff and consumers safe.
But in recent days, it is considered first which is not right. Seclusion is considered as the most
favorable method compared to the rest of the methods which include physical and mechanical

MENTAL HEALTH 3
restraints. Nurses in conjunction with the consumers disagree with the seclusion method as it was
traumatic to the patients who are mentally ill (Lomas et al., 2017). Therefore, they were for
elimination of seclusion & restraint method. Factors that are considered to decrease the
incidences of restraint & seclusion included creation of a good relationship between the staff and
consumers and making use of the principles of trauma-informed care. Nurses have this notion
that they can use clinical skills to ensure their safety from the aggressive patients rather than
restrictive practices. There exist many initiatives at variable levels that are required to maintain
the healthcare professionals' and consumers safe. These initiatives also move towards realizing
directive measures to eliminate & reduce use of restraint/seclusion practices (Kinner et al.,
2016).
Restrictive practices are used to manage risks or prevent harm due to the patients’
behaviours which may include self-injury, aggression and violence. The restrictive practices are
being considered deleterious since they have physical effects & psychological effects on the
consumer & staff besides complex ethical and legal issues are associated with help of restrictive
practices. Internationally and in Australia, there has been great pressure from the mental
healthcare professionals and consumers to eliminate/reduce coercive and restrictive practices
(Slemon, Jenkins & Bungay 2017). It has been shown that there is a reduction in the use of
seclusion a3nd restraint in Australia but there is still persistent of seclusion practices, mechanical
& physical restraint practices several times with the one consumer or prolonged use on the same
consumers. This calls for an immediate need for better understanding & use of restrictive and
coercive practices and finally, experience of staff working with the mental healthcare consumers
in inpatients (Brunero & Lamont, 2010). Seclusion has shown negative impacts on consumer's
mental healthcare status which includes; consumers argued that seclusion of patients lack

MENTAL HEALTH 4
accountability for the patient’s human rights since the patients were locked in a secluded room
out of their will. The patients are left in a powerless situation since they are robbed of the right of
expression. Seclusion also causes trauma to the consumers. The consumers explained that they
were locked in a room which lacked toilets and left for hours and they were expected to get cured
(Gopalakrishnan, Ambrose & Harvey 2019). This makes it a traumatic experience hence it
affects the recovery process of the patients. Another impact of seclusion is that it is inconsistent
with personal recovery hence it leads to anti-recovery. Nurses have reported that recovery
involves self-direction, self-responsibility which is in contrast to seclusion which is all about
someone else’s control hence it does not help in recovery. Seclusion is also dehumanizing, the
consumers reported that they were not treated normally aa the rest of human beings (Larue et al.,
2016). For instance, being brought food on a tray and left on the door of the cage without any
word from the caregivers they were treated without trust and that not only dehumanizing but is
also demoralizing. Seclusion practices have a positive impact on the healthcare professionals.
Firstly, seclusion enables the professional’s safety. When the aggressive consumers are enclosed
in a secure room, the rate of injury that the consumer is expected to cause is lowered (Mann-Poll
et al., 2018). Hence ensuring safety environment for the professionals. The Seclusion of
aggressive consumers promote a conducive working environment for the patients since they are
controlled and minimizes the healthcare professional workload.
The agenda in Australia for the last decade to reduce & eliminate restraint/seclusion is
reflective in several clinical initiatives and key policy and government directives. The National
Health Consumer and Carer Forum gives a direction that restraint and seclusion aren’t
“evidenced-based therapeutic interventions” and are mostly associated with the abuse of human
rights, the practices also causes both long-term and short-term damages towards the consumer's