Patients locked up in mental health wards for more than 20 hours

He said representatives from NSW Health had met with management of hospitals with high isolation times and devised strategies to minimize their use.

But sometimes he said that de-escalation strategies don’t work, or that patients become manic or psychotic and aggressive without any warning.

“The point of seclusion is that it’s a safe place,” said Dr Bowden of the enclosed, simple rooms with low light, a mattress and soft walls with no ligature points. Staff regularly monitor a secluded patient, usually through a window on the door.

The majority of patients admitted to NSW mental health units have never been isolated. Only 3.5 percent of the 11,249 mental health admissions involved at least one “seclusion episode” from January to March this year.

“But each one is too much from our perspective, and we’re working to reduce that and eliminate it completely where possible,” he said.

dr. Bowden said COVID-19 restrictions that separated patients from family and the outside world had exacerbated vulnerable patients’ fears and made it harder for them to curb risky or aggressive behavior.


A Cumberland Hospital spokeswoman also said COVID-19 restrictions have contributed to the frequency and duration of separation episodes. Among the sequestered patients were COVID-positive people.

Sydney Local Health District, which oversees Concord Hospital and the mental health department of the Royal Prince Alfred Hospital, said they had a lower threshold for using isolation rooms to isolate non-compliant patients with COVID-19 if their behavior personnel or other patients at risk of infection.

Some of the Liverpool hospital segregations were also people who had COVID-19, a spokeswoman for South Western Sydney Local Health District said.

dr. Michael Hazelton, co-professor of mental health at Newcastle University, said the Omicron wave had put enormous strain on a mental health system that failed to recover after Delta.


Staff shortages meant that gaps were sometimes filled by nurses from other departments who were not well versed in de-escalation strategies developed with individual patients and their families, Hazelton said.

“Virtually no nurses go into mental health care with anything but the absolute best intentions for the people they work with,” he said. “But many nurses who work in these services most likely do not have a formal qualification in mental health,” he said.

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