Solitary seclusion for Bay patients

More than 100 mental health patients spent nearly 5000 hours in solitary confinement last year in the Bay of Plenty - and just three patients accounted for over a third of all cases.
Bay of Plenty District Health Board uses seclusion - solitary confinement in bare rooms - at its Tauranga inpatient unit Te Whare Maiangiangi and at another facility in Whakatane, but is trying to cut down on the unpopular practice by using new forms of therapy.
Figures released under the Official Information Act showed seclusion was used 57 times, accounting for just over 600 hours in confinement, at the units between January and March this year.
Last year, 110 patients spent 4877 hours in seclusion and three patients accounted for 104 of the total 286 cases.
Data for last year also showed how patients at the Tauranga unit went into seclusion for about 1100 hours in May, a dramatic jump from approximately 200 hours the month before.
The health board has blamed the spike on the smokefree ban it introduced to its mental health units that month, and reported that violence on staff by patients and the use of restraint peaked until the total ban was relaxed three months later.
Health board chief operating officer Phillip Balmer said some patients did experience distress when confined to rooms alone, however no complaints about seclusion had been made by family members.
"Seclusion has shown to be a safe and effective way of managing patients when their behaviour and or mental health condition endangers themselves, staff or other patients," Mr Balmer said.
While seclusion could be used as a therapy or as a containment procedure, it was illegal for health boards to use it as a form of punishment. Standard practice was to seclude patients only when their behaviour endangered themselves, staff or other patients, Mr Balmer said.
The length of time Tauranga patients spent in seclusion was approximately 12 to 14 hours on average, but this included time when the patient was sleeping at night.
"The room is entered by a staff member if safe to do so every 30 minutes to check on the condition of patients and determine whether seclusion can be ended.
"In general, family members, patients' rights groups and mental health staff don't like to use seclusion any more than necessary and this is the reason for the projects to reduce the use of seclusion."
One project focused on "sensory modulation therapy", involving designated rooms with audio visual equipment and supervision by specialist healthcare workers, as an alternative to seclusion.
In 2009, Bay of Plenty District Health Board had the fourth highest rate of seclusion cases, behind Canterbury, Northland and Taranaki.
However, Bay of Plenty's rates were higher than average because it had no secure forensic unit for high-risk inpatients.