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Mental Health Units Breach UN Convention

The Chief Ombudsman is calling for action to address serious and persistent issues at some of the country’s mental health units.

Peter Boshier has the role under an international human rights convention to inspect places of detention, where people are unable to leave at will. Today he released reports on five secure acute mental health units inspected before the COVID-19 restrictions began in March.

‘Two of the facilities we inspected were in breach of the United Nations Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment,’ says Mr Boshier.

‘Te Whare o Matairangi Mental Health Inpatient Unit at Wellington Hospital continued to use seclusion rooms as bedrooms when the unit was over capacity, despite my recommendation in 2017 that this practice should stop.

‘These rooms contain little more than a mattress, and are supposed to be used as a short-term measure for patients who are assessed as an imminent safety risk.'

Mr Boshier says putting patients in seclusion rooms for no reason other than a shortage of accommodation has the potential to cause significant physical and psychological impacts.

‘I consider the ongoing use of seclusion rooms and other spaces as bedrooms amounted to degrading treatment and a breach of Article 16 of the Convention.

‘Similarly, the Waiatarau Mental Health Inpatient Unit at Waitakere Hospital was using its intensive care unit (ICU) as long-term accommodation for a patient. The patient was missing out on approved unescorted leave, was unable to attend daily programmes, and had limited access to phone calls.

‘While the patient had originally been moved to the ICU because of the risk of violence, there was no evidence this risk still existed. What was clear from clinical notes was that being contained in the ICU for an extended period was causing the patient an escalating sense of hopelessness, frustration and anger.

‘It is my opinion that the long-term accommodation of the patient in the ICU amounted to cruel or inhuman treatment under Article 16 of the Convention.’

Mr Boshier says there were other problems common to many of the units, for example overcrowding, unduly restrictive practices, low staffing levels, and lack of privacy for patients using the toilet.

‘I have raised my concerns with Parliament, the Ministry of Health, District Health Boards, and the facilities themselves, and will continue to do so to ensure that vulnerable people are treated with dignity and respect that meets international expectations.

‘As a nation, we are moving in the right direction in recognising mental health as a significant issue, and investing in improving the mental health of our citizens. But these reports show there is still urgent work to be done.

‘On a more positive note, some of the units were functioning well in caring for their highly vulnerable patients,’ says Mr Boshier.

‘Relationships between staff and residents were on the whole positive, and patients generally had good access to activities and health care services. Most of the units also encouraged visits from whānau, which is an important aspect of treatment and recovery.’

Reports have been published on the following units:

- Te Whare o Matairangi Mental Health Inpatient Unit, Wellington Hospital

- Waiatarau Mental Health Inpatient Unit, Waitakere Hospital Campus, Auckland

- He Puna Wāiora Mental Health Inpatient Unit, North Shore Hospital Campus, Auckland

- Tumanako Mental Health Inpatient Unit, Whangarei Hospital Campus, Whangarei

- Kensington Centre Mental Health Inpatient Unit, Timaru.

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