Victorian children are increasingly being physically restrained in the state’s public mental health facilities, despite the recent royal commission recommending the practice be phased out within 10 years.
A damning report by the state’s peak mental health body, the Victorian Mental Illness Awareness Council (VMIAC), has revealed a system that is still secluding and restraining people more frequently and for longer than national averages.
La Trobe University mental health expert and former VMIAC deputy chair Dr Chris Maylea said the state was going backwards against some of the royal commission’s recommendations.
“The fact that we’re seeing a year on year increase across so many different areas, including compulsory treatment, seclusion and restraint for specific groups is very disappointing,” he said.
Seclusion involves sole confinement of a person to a room where they cannot leave. Physical restraint refers to hands-on control of a person’s body while mechanical restraint involves the use of straps or other devices to restrict movement of someone’s body. The UN’s special rapporteur on torture has advocated for a ban on all coercive practices such as restraint and solitary confinement of people with psychological or intellectual disabilities.
The royal commission into Victoria’s mental health sector – which handed down its final report in February last year – recommended the state government act immediately to end the use of seclusion and restraint in mental health facilities within 10 years. But VMIAC has urged the state government to expedite the elimination of seclusion and restraint, labelling the outdated methods breaches of human rights.
During 2020-2021 there were 7,461 instances of seclusion and physical and mechanical restraint in 26,884 admissions to Victorian public hospital mental health services. In child and youth units there were 1,039 instances of physical restraint – up 32% from the previous year. In adult mental health units, 56% increased their use of mechanical restraint in 2020-2021.
The report found First Nations Victorians were restrained and secluded at higher rates than the general population, making up 3.5% of all inpatients, but 5.3% of all seclusions.
The report also revealed a large disparity in the use of seclusion and restraint between services across the state. The report’s analysis found people who lived in Ballarat were 6.3 times more likely to be secluded than people in Traralgon, while residents of St Albans were 14.8 times more likely to be secluded than people in Frankston.
Maylea said the variation in seclusion and restraint across services highlighted it was possible to eliminate the methods.
“It’s not as if we are asking for something that is impossible to achieve here. What we want is already being done – it just needs to be done everywhere,” he said.
Last year’s royal commission report found an over-burdened system was crisis-driven and not designed to support people living with psychological distress or mental illness.
It recommended the creation of a new mental health and wellbeing commission – that will absorb the existing mental health regulator – to monitor the government’s delivery of the inquiry’s reform.
In response, last year’s state budget included a mental health and wellbeing levy on big businesses that is forecast to raise $843m each year to fund mental health services. The levy, which began in January, was a recommendation of the royal commission.
A Department of Health spokesperson said it was expanding the use of emergency department crisis hubs to reduce conflict and the need for restraints or seclusion.
“While we’ve made improvements when it comes to the issues of seclusion and restraint, we know there’s more work to do,” the spokesperson said.
“The royal commission told us that restraint and seclusion need to be dramatically reduced – and that’s exactly why we’re implementing every single recommendation to make sure Victorians get the safe care they deserve.”
