The World Health Organization (WHO) has released guidelines that lash out against coercive psychiatric practices including the use of restraint, stating that “coercive practices such as restraint and seclusion cause harm to physical and mental health and can lead to death.”¹

Restraint is the psychiatric practice of subduing or controlling a patient through the use of powerful psychiatric drugs, physical force or such items as harnesses, straps or even manacles.

According to the NSW Health Department, “There have been instances both in Australia and internationally in which young apparently healthy people have died suddenly while held in physical/manual restraint. Resuscitation attempts in these circumstances have rarely been successful.”²

An involuntarily detained patient at Graylands hospital in Western Australia repeatedly told staff restraining him to let him go and said, “You are going to kill me,” moments before he slumped to the ground and died. A post mortem found significant bruising on his neck and that death was consistent with cardiac arrhythmia during restraint.³

In Australia in 2019/20 there were a staggering 18,352 physical⁴ and 1,213 mechanical restraint “events.”⁵ The rate of mechanical restraint on children and adolescents was 250%⁶ higher than the previous year and the rate of physical restraint was 12.8%⁷ higher than the previous year.

There are no bans on restraint in any Australian mental health act, including for use on children, pregnant women and the elderly.

Please contact your local Member of Parliament and Health Minister and ask them to make changes to your state’s mental health act so that restraint is banned and criminal penalties apply for its use. To find their contact details:

ACT: https://www.parliament.act.gov.au/
NSW: https://www.parliament.nsw.gov.au/members/Pages/all-members.aspx
NT: https://parliament.nt.gov.au/members/by-name
Qld: https://www.parliament.qld.gov.au/members/current/list
SA: http://www.parliament.sa.gov.au/Members/Pages/Members.aspx
Tas: http://www.parliament.tas.gov.au/ha/halists.pdf and http://www.parliament.tas.gov.au/lc/lclists.pdf
Vic: https://www.parliament.vic.gov.au/about/people-in-parliament/members-search/list-all-members
WA: http://www.parliament.wa.gov.au/parliament/memblist.nsf/wallmembers

References

1. “Guidance on Community Mental Health Services: Promoting Person-Centered and Rights-Based Approaches,” World Health Organization, 10 June 2021, p216. https://www.who.int/publications/i/item/9789240025707 (to download report)
2. “Aggression, Seclusion & Restraint in Mental Health Facilities in NSW,” NSW Health Policy Directive, next Review Date for this publication is 31 December 2019, (original publication date: Date 26 June 2012), p. 9.
3. “’Misadventure’ as psychiatric patient died,” WA Today, 22 November.2011. https://www.watoday.com.au/national/western-australia/misadventure-as-psychiatric-patient-died-20111122-1nsoc.html
4. Table RP.8: Restraint rate, public sector acute mental health hospital services, states and territories, 2015–16 to 2019–20. Row 6 – Number of physical restraint events; Column G. https://www.aihw.gov.au/getmedia/44d86d6e-dea1-48c1-9e85-faf0152836df/Restrictive-practices-tables-2019-20.xls.aspx
5. Table RP.8: Restraint rate, public sector acute mental health hospital services, states and territories, 2015–16 to 2019–20. Row 5 – Number of mechanical restraint events; Column G. https://www.aihw.gov.au/getmedia/44d86d6e-dea1-48c1-9e85-faf0152836df/Restrictive-practices-tables-2019-20.xls.aspx
6. Table RP.9: Restraint rate, public sector acute mental health hospital services, by target population, 2015–16 to 2019–20. Row 6 – Rate of mechanical restraint; Child and adolescent. Column F & G. https://www.aihw.gov.au/getmedia/44d86d6e-dea1-48c1-9e85-faf0152836df/Restrictive-practices-tables-2019-20.xls.aspx
7. Table RP.9: Restraint rate, public sector acute mental health hospital services, by target population, 2015–16 to 2019–20. Row 11 – Rate of physical restraint; Child and adolescent. Column F & G. https://www.aihw.gov.au/getmedia/44d86d6e-dea1-48c1-9e85-faf0152836df/Restrictive-practices-tables-2019-20.xls.aspx