13 Nov 2013

No 'big stick' approach to seclusion rates

11:16 am on 13 November 2013

The Government's top mental health advisor says he will not try to force hospitals to do more to cut the amount of time Maori patients spend locked in seclusion.

Maori are put into seclusion more than twice as much as non-Maori but health officials say they're starting to reduce those rates.

While seclusion rates are slowly falling, for Maori patients they're still high, meaning they're spending more time locked in a sparsely furnished unit.

Under the law, Director of Mental Health John Crawshaw can launch a commission of inquiry into how people are treated.

But Dr Crawshaw says people are co-operating and working effectively to drive down seclusion rates.

"I think it is much better that we get sustained change through the DHBs working collaboratively with their consumers and carers and with each other to drive it down rather than to use a big stick."

Despite Northland's sizeable Maori population, statistics from the district health board show Maori are over-represented in its seclusion figures.

Roy Johnson manages the mental health unit in Whangarei and says they've made changes that are helping to reduce seclusion, including boosting Maori staff levels from 20% to 50% in just four years.

Tairawhiti District Health Board has in the past put a lot of Maori patients under lock and key, but today there's high praise in the mental health sector for some new initiatives on the East Coast.

Clinical care manager Te Pare Meihana says in January they put eight people under lock and key, and by June that tumbled to just one.

She puts the success partly down to local elders coming on the wards to talk to patients to provide a meeting of cultural minds.

Te Pare Meihana also says big gains can be made from a small, simple step. She says they bought a massage chair, which soothes and calms patients.

In the South Island, Stu Bigwood is the director of nursing for the specialist mental health service at Canterbury DHB, where he says seclusion is used as a last resort. He says Canterbury is steadily shutting its specialist rooms, closing one a year over the past six years, leaving 10 open.

While Dr Crawshaw says his ultimate goal is to eliminate seclusion, he doesn't want its use to come to an abrupt end through the use of drugs.

He says medications have their place, but there have been cases overseas where sedation has been used to reduce seclusion and that approach doesn't help patients fully recover.