More patients being restrained

The use of restraints on mental health patients at Northland's hospitals have doubled over the past three years.Photo / File

Incidents involving Northland mental health patients requiring restraint have more than doubled in the past three years despite a national plan asking providers to reduce numbers.

Figures show Northland DHB mental health services restrained inpatients 77 times in 2014, up from 35 in 2012, with the rise a concern to health leaders.

Most of these were patients deemed a risk to themselves or others.

Maori Health and Mental Health and Addiction Services general manager Kim Tito said complex conditions often meant restraining inpatients was necessary.

She said restraint was a negative experience and the rise in incidents was cause for concern.

The Ministry of Health's 2012 mental health and addiction plan asked DHB providers to "reduce and eliminate the use of seclusion and restraint".

The five-year Rising to the Challenge plan cited national and international best-practice examples.

"While it is a challenge for services to meet such a goal, it is essential to strive for this in keeping with national and international expectations for reduced restraint use in mental health care," said Ms Tito.

Restraint is any intervention which intentionally removes the normal right to freedom, which the ministry said was "a serious intervention that requires clinical rationale and oversight".

Mental Health Foundation chief executive Judi Clements said providers should aim to eliminate restraint entirely.

"We should be moving away as much as possible and as fast as possible from coercive methods - whether that's use of seclusion or forced treatment or restraint," she said.

"I know that some of that is the intended direction of policy but whether that is happening often enough or quickly enough is another question."

Ms Clements said mental health patient care must be respectful and as least restrictive as possible.

"If we're working with people who are in distress, we want to alleviate their distress, not in any way add to it," she said. "Things that are particularly coercive and would be deemed as disrespectful or invading people's physical space or liberty should be avoided."

Ms Clements said New Zealand compared well with many other nations but there was room for improvement.

"We're doing reasonably well, but don't deserve any prizes - put it that way. We need to get away from acute wards, large numbers, people in distress, staff under pressure. That should be the journey we're on, but it doesn't seem to be fast enough."