Dr. Norella Broderick:

The current standards require that seclusion or restraint only be initiated when there is an immediate risk of serious harm to the patient or to someone else on the ward. The people who are admitted under the Act or who are in secure units and might potentially be restrained are the most unwell people. One thing that comes to mind when talking about this is improving the use of de-escalation and ward atmospheres. That is important for us to consider, as is having adequate facilities and nursing staff on the wards to make sure patients can be managed as effectively as possible with de-escalation to reduce the need for restraint or seclusion. We need to consider whether we have adequate nursing staff. Maybe the nursing unions will be able to speak more about that. We do not know of any country in the world which has successfully eliminated seclusion and restraint. There are always extreme situations where somebody is very disturbed, as has been described. For their own safety and that of others, some kind of intervention will be required.