Restrictive Practices in Australian mental health services

Running head: Restrictive practices in Australian mental health services
Restrictive practices in Australian mental health services
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Restrictive practices in Australian mental health services
Introduction
Seclusion and restrictive practice have been used in the health care settings in the
psychiatric and mental health unit for controlling patients with aggressive and violent behaviors.
However, evidences show that these approaches have negative impact on both the consumers as
well as the healthcare professionals. Although, Restrictive practices are perceived as the only
way of restraining a consumer’s behavior with violent behaviors, it has been found to be
associated with negative impacts on the consumer’s life. Seclusion and restraint are measures
currently allowed to monitor or regulate the actions of an adult in mental health services. Severe
concerns have been raised in Australia at least since 1993 about the use of this reclusion and
maintenance (Haugom, Ruud & Hynnekleiv, 2019). Acute medical facilities are a difficult
environment in today's Australia's Mental Health System, where a high proportion of patients are
admitted accidentally, for example 57% of the Victorian hospital admissions for 2016–2017 have
been involuntary. It is reported that 2-3% (around 600, 000) of Australians have a condition of
extreme insanity or depression and that about 0.5% have certain types of psychotic disorder,
which are mostly diagnosed with schizophrenia (Brophy et al., 2016). State or territory has
legislation on mental health which allows people with severe mental health problems to be
detained for mandatory care with strict criteria. Seclusion and restraint are interventions
commonly allowed for the intent of handling or monitoring a person's behavior in mental health
and other environments. Seclusion usually refers to an individual's conscious isolation alone in
the space or place he or she is unable to escape. The implementation of seclusion is controlled by
the mental health laws of each State or territory.

Restrictive practices in Australian mental health services
Discussion
The impacts of seclusion to consumers and healthcare professionals alike:
Significant concerns have been raised in mental health services at least after 1993 about
the use of seclusion and mechanical control. Consumers and caregivers are primarily voicing
negative perceptions of seclusion and restriction while at times finding certain advantages for the
coercive procedure and are reluctant to accept the measures as therapeutic (Brophy et al., 2016,
Kinner et al., 2017). In previous studies involving patients with input about their experience in
hospital services, several barriers have been established to deliver services that lead to consumers
' safety and treatment needs. Patients complain that hospital care facilities are custodial and
sterile, have rigid and subjective guidelines and are not consistent and conscientious to patients.
Consumers complain dull, overwhelmed and anxious and that workers have no time to engage in
counseling (Fletcher et al., 2019). Nurses articulate a wide variety of points of view on isolation
and retention: from fear, avoidance and approval of even therapeutic intervention. Reports also
reported adverse observations of serious physical injury as well as questions about the denial of
rights, conflict of personal integrity and loss of dignity. Many reports have acknowledged
negative consequences for the seclusion and mechanical repression of persons and have raised
concerns regarding violations of human rights. Consumer physical retention and containment
encounters, which have been recorded to be extremely negative, are related to acute worsening of
anxiety and intense feelings of fear, humiliation, panic and anger. The patients were stated to
experience: afraid, nervous, agitated, powerless, embarrassed and vulnerable; lost, rejected,
disqualified and ignored. Before, during and after accidents, harms have been experienced. Many
comprehensive implications include: a sense of injustice, retribution and impotence. There have

Restrictive practices in Australian mental health services
been a small number of consumers reporting negative interactions that reflect poor practices of
seclusion and maintenance, including patronizing contact. In another analysis, participants
reported that both the workers were disciplined and discarded for' non-professionals' (safety /
advisors) in particular (Prophy et al., 2016). A small number of studies, or a subset of
participants in the study, indicate positive opinions such as: that seclusion was a therapeutic tool,
or that the use of retraction has a calming effect. The security and protection of seclusion rooms
and the fulfillment of their physical needs were acknowledged by patients in other report.
Ultimately, the negative effects will mask variations in perceptions, people and climates. In this
sense, there could be significant differences between bad and best methods and the impacts that
might be correlated with them. In this context, consumers carers, experts and policymakers have
given greater attention to use of seclusion and restriction. One of the main guidelines of the
Australian Mental Health Commission (2012) in Australia are "to minimize harmful behaviors
and work to eliminate alienation and attachment." And, in New Zealand, Te Pou Te Whakaaro
Nui, the NCRI, laid out a plan for "best practice" to improve however eliminate mental health
(Brophy et al., 2016). In the Australian Institute of Health and Welfare, reduction in the use of
seclusion and confinement was reported (Australian Institute of Health and Welfare, 2018).
Seclusion, physical and mechanical control are still common practices but recent studies have
pointed out considerations such as the repeated use of these techniques with the same users
(Oster et al., 2016) or for long-term stretches (McKenna et al., 2017). It illustrates the critical
need for employees working with the customer in hospitals and EDs to better understand the use
of these procedures and interactions.
The Restraint and Seclusion in Mental Health Services Policy was thus, developed by the
Government of South Australia with the aim to provide staff with information for implementing