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Restrictive Practices in Australian Mental Health Services

13 March 2020

Restrictive and coercive practices not only violate the fundamental human rights of people with mental ill-health, but also impact significantly on their physical and ongoing psychological health. This NMHCCF position paper includes three true stories provided by members of the NMHCCF.  These stories highlight the impacts for people with lived experience of restrictive practices.

Towards the elimination of restrictive practices

It is the position of the NMHCCF that it must be the aim of Australia’s mental health services to work towards the elimination of restrictive practices, including seclusion and all forms of restraint as described by this position paper. The NMHCCF contends that, despite the work done around restrictive practices across the country, both the prevalence and use of involuntary treatment, seclusion and restraint remain far more widespread and insidious than can be justified as last resort emergency (safety) measures.

Regarding involuntary treatment, - in the form of Involuntary Treatment Orders (ITOs) and Community Treatment Orders (CTOs) – the NMHCCF concurs with the NSW Mental Health Commission, which states that ‘a high number of ITOs, in hospital or in the community, means that we are not helping people early enough when they experience mental distress or increasing illness. Treatment in hospital should be a last resort for people and their families. Involuntary treatment can be very traumatising or re-traumatising for the person involved.’

NMHCCF Recommendations

The position of the NMHCCF is that restrictive and practices and involuntary treatment:

  • Highlight a failure in care and treatment where they are used.
  • Are not evidence-based therapeutic interventions.
  • Are avoidable and preventable practices.
  • Epitomise a workplace culture of tension and antagonism between consumers and families/ carers and clinical staff.
  • Precludes the development of trust and respect between consumers and families/ carers and clinical staff, leading to fear and distress among consumers and a breakdown of therapeutic relationships.

Read the full position paper now: Restrictive Practices in Australian Mental Health Services: Position Paper