This fact sheet outlines the actions being undertaken by NSW Health to improve accountability and governance in mental health care following the Review of seclusion, restraint and observation of consumers with a mental illness in NSW Health facilities.
Following the ‘Review of seclusion, restraint and observation of consumers with a mental illness in NSW
Health facilities’, we will implement the following recommendations:
Every local health district and specialty health network will invite patients, carers and their families to be
included in designing their prevention action plans. To find out more, contact your local health district.
Clinical governance helps sustain and improve high standards of patient care. It includes methods to monitor
the standard of care that health services provide. This requires clear communication and strong partnerships
between the executive team, managers and other staff in health services. Reliable clinical governance
processes are essential for patient safety, including the prevention of seclusion and restraint.
In most organisations, critical decisions are made in executive forums. Mental Health Directors need close
working relationships with Chief Executives and other directors in their health service. Health services need
strong, visible and engaged mental health leadership at the highest level to drive through ambitious
NSW Health has a number of policies and guidelines that refer to the use of seclusion and restraint. Complex
policy requirements can be confusing and limit quality improvement. The Review of seclusion, restraint and
observation of consumers with a mental illness in NSW Health facilities recommended simplifying with a
single principles-based policy. A simpler, principles-based statewide policy will make it easier for local health
districts and specialty networks and guide quality improvement.
The review team heard that the smoke-free health care policy had contributed to consumer aggression
which then led to episodes of seclusion and restraint. International research evidence has found the opposite
effect. Introduction of a smoke-free policy, supported with a range of nicotine replacement therapies, has
helped reduce physical assaults in several psychiatric hospitals. Based on this evidence, the review
recommended better support for implementation of the policy and nicotine replacement therapy.