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Ethically unacceptable that ‘seclusion used as punishment’ – report

This is in spite of rules advising that seclusion be used for the shortest possible time only and evidence that long periods of seclusion is anti-therapeutic.

The finding is contained in the newly published 2016 annual Report of the Inspector of Mental Health Services, which states that, “it is ethically unacceptable that seclusion is used as punishment”. The report described seclusion as “solitary confinement”.

Centres using seclusion must inform the Inspector if seclusion is extended beyond 72 hours. But the report found that 84 per cent of centres using seclusion were non-compliant with the rules governing its use.

“There are serious concerns about the use of seclusion in approved centres. These include the reasons for secluding service users, lengthy periods of time that a service user is in seclusion, the use of seclusion as punishment and lack of efforts to reduce the use of seclusion and restraint,” the report states.

The lack of regulation of community residences was also highlighted. The report outlines that this is putting 1,355 vulnerable adults at risk of abuse and of not receiving adequate mental healthcare and physical care.

“There is inadequate provision of on-call emergency child and adolescent services in many parts of the country,” the report adds. 

Extensive non-compliance with privacy and dignity was also found. The report describes the lack of provision for privacy in 59 per cent of approved centres as unacceptable.

The report, however, acknowledges that most services are working hard to be compliant with rules and regulations.

Last year, the Inspector inspected 64 centres. All inspections were unannounced. 

Other mental health services, including 24-hour supervised residences, were not inspected in 2016 due to a lack of staffing resources in the inspectorate team.

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