Background to the review

In 2022 the Office of the Chief Psychiatrist, in collaboration with authorised mental health services, established the review into how seclusion and mechanical and physical restraint is used in Queensland's mental health service system.

The independent review was established under the Mental Health Act 2016. The Review into the use of seclusion, mechanical restraint and physical restraint under the Queensland Mental Health Act 2016 report (PDF 8182 kB) was published in November 2023.

The goal of the review was to identify themes, lessons and actions to improve mental health clinical practice. It also aimed to identify opportunities for how we can reduce and, where possible, eliminate the use of seclusion and restraint.

Dr Nathan Gibson, the Chief Psychiatrist of Western Australia, led the review. The following authorised mental health services (AMHSs) took part:

  • Children's Health Queensland – child and adolescent service
  • Redcliffe-Caboolture – secure mental health rehabilitation service
  • Wide Bay Hospital and Health Service – adult acute service

The oversight role and functions of the Office of the Chief Psychiatrist were also reviewed.

Recommendations

The review made 18 recommendations across the following areas.

 
  • The active participation of persons with lived experience, their families and carers is fundamental to reducing and eliminating seclusion and restraint
 
  • First Nations expertise and input is essential to supporting culturally safe and capable services that use least restrictive practices
 
  • The Office of the Chief Psychiatrist has a pivotal role in bridging regulatory requirements with clinical practice to support services using alternatives to seclusion and restraint
 
  • Leadership and a culture that supports learning and improvement is fundamental to reducing the use of seclusion and restraint
 
  • Models of care adopted by inpatient services must focus on delivering alternatives to seclusion and restraint
 
  • A skilled and engaged workforce, working to their top of scope, is required to support whole of system approaches to reducing and eliminating seclusion and restraint
 
  • Environmental enhancements ranging from minor practical changes to purpose built designs can be made to support alternatives to seclusion and restraint
 
  • Information, including data, must be used as an enabler to deliver transparency and promote responsibility and accountability

Our response

Read the Queensland Health response (PDF 202 kB) to the report which outlines key activities which are occurring to improve and enhance the service system. Many of these activities are being delivered as part of Better Care Together - a plan for Queensland's state funded mental health alcohol and other drug services to 2027 and include:

  • funding lived experience and First Nations leadership positions to support and facilitate better engagement and co-design across mental health services system initiatives
  • enhancing leadership capability across the service system by developing safety priorities and position statements that focus on minimising, and where possible, eliminating the use of seclusion and restraint in mental health settings
  • establishing a Centre for Excellence that will support responses to the mental health needs of children and adults living with intellectual or developmental disability and their families and carers
  • enhancing our mental health, alcohol and other drugs workforce capability to ensure it is a responsive, capable, dedicated, sustainable workforce that displays resilience to adapt and respond flexibly to shifts in service delivery and new and enhanced models of care
  • improving our digital capability and supporting consumer ownership of care via information access and control.

Last updated: 5 September 2024