Restraints and Human Rights.

Emma 00:00

The reality of restraint can leave people feeling very vulnerable. 

00:05

You know, the services response to me at that time was to was to physically restrain me, or they call it mechanical restraint, I think so that's to shackle you to a bed, and then I was left, you know, shackled to a bed for, I think, roughly 48 hours. But I'm, I'm not sure, because my memory is, you know, pretty hazy of those times. And you know, when I think about it, the thing that I wanted, or what would have helped me most in that moment, is just a person you know, a nurse or a social worker or a peer worker, someone to sit with me, you know, probably continue to remind me you're in hospital, you're safe, hold my hand. Get me a cup of tea. Megan

Emma 00:44

Burke's experience was many years ago, but Clinical Professor of Psychiatry at Monash University, Richard Newton says restraint is still being used. If

00:58

you speak to the mental health clinicians, they would say that they were doing them from the very best of motives, that they were doing them because that person was at risk of harm to themselves or to other people or at risk of major deterioration, and that part of their role as mental health clinicians is to make these very hard decisions on behalf of somebody who, by dent of the level of psychological distress or psychiatric illness, don't have capacity to make those decisions for themselves.

01:29

It takes a very long time to put yourself back together after something like that, and you you come away from them feeling like there must be something really deeply wrong with me that this has happened to me and it feels like you've you've crossed a threshold, and how ill or crazy I must have been for these things to happen to me, it's taken me a really long time to learn that these things didn't happen because I was so ill. They happened because our systems are not set up to appropriately and safely care for people in distress. And what's most kind of egregious about that is they often do these things in the name of looking after you. I think it's because we haven't given services and clinicians an alternative way providing care. They don't know what to do instead? One

Emma 02:21

person with an alternative approach is Simon Cattell. Last year, he was commissioned by Victoria's mental health minister to advise on acknowledging harms in the state's system. 

02:37

We've seen some progress on elimination of seclusion and restraint, but in the last quarter, in our data, we've actually seen a significant increase in the use of seclusion, for example, so we're not seeing the kinds of changes that were promised. Part of that is that we haven't really brought the community along to understand the significance of these human rights abuses. And the other issue is there's very little accountability for that unnecessary use in Victoria, we've got a mental health and wellbeing commission that oversees mental health services, kind of like the NDIS safeguards Commission. They said that this commission has had over 18,000 human rights complaints over 10 years and has never issued a single compliance notice across those 10 years. We aren't eliminating seclusion and restraint at the levels that we should, because there's no consequences for doing it unlawfully. Megan

Emma 03:29

Burke now works for the make who work with consumers to end restrictive practices and says more lived experience is needed.

03:40

I do think if we had people who had a lived experience of these practices, who were embedded throughout organizations, you know, in the governance of these organizations, that that would go a long way to making a difference. You know, I sit on this committee in the Office of the Chief psychiatrist. I don't know. There's 20 people who come along every couple of months to talk about trying to eliminate restrictive practices, and I'm one of maybe two people in that whole meeting who has a lived experience of being a mental health service user, and probably the only person in that meeting who has a lived experience of restrictive practices. Megan

Emma 04:14

says the one Victorian service Peninsula health has consciously eliminated restricted practices, so argues it can be done well. As part of his work, Simon Catal has offered governments this advice to end with addictive practices. There

04:35

would be a national restorative justice process that took place in communities over in Wodonga, in Cairns, in the Kimberley, where those communities can speak to each other to learn about the harm that's occurred and then come to a shared consensus that we we don't want to have systems like this anymore. We want our systems that people get help from, not ones that they're hurt in, so that we can draw along. One behind the system that we don't want anymore, and figure out the system that we want to create in the future.