Paradigm shift away from seclusion and restraint is needed says new report

Paradigm shift away from seclusion and restraint is needed says new report

December 10, 2020

New research has found high use of seclusion and restraint in prisons, children and young people’s residences and health and disability units, particularly of Māori and Pacific Peoples, prompting calls from the Human Rights Commission for detention agencies to shift their practices.

“Seclusion and restraint are used too often, for too long, often without a convincing justification and more frequently against Māori and Pacific Peoples,” said Chief Human Rights Commissioner Paul Hunt.

The findings come from a new report titled Time for a Paradigm Shift A Follow Up Review of Seclusion and Restraint Practices in New Zealand undertaken by Dr Sharon Shalev of the Centre for Criminology at the University of Oxford, at the invitation of the Human Rights Commission.

The report is a follow up of a highly critical 2017 review of seclusion and restraint practices in New Zealand also published by the Commission. This follow up review was supported by the Children’s Commissioner.

The follow up review found women in prison were segregated at a far higher rate than men, and Māori women were segregated for longer and at a far higher rate than other women, making up 78% of all stays in the most restrictive form of segregation (‘Management units’) in 2019. The use of force and restraints remained high and, in some areas, has significantly increased since 2017. 

The research found some positive developments since 2017, including a national effort to reduce the use of seclusion and restraint in health and disability facilities, an end to the use of ‘tie down’ beds in prisons and a greater commitment to Māori culture and values in the care of children and young people by Oranga Tamariki.

 “The overall picture, however, is disappointing and many of the issues highlighted in my 2017 report have not been addressed”, said the report’s author Dr Sharon Shalev. 

“Too many people continue to be held for too long in sparsely furnished rooms and cells, with limited access to fresh air and exercise, and with little access to meaningful human contact.”

The Human Rights Commission is calling on agencies to reduce, if not eliminate altogether, the use of seclusion and restraint.

“We know that the practices of seclusion and the use of restraints, particularly where they are used for prolonged periods, are inherently harmful. However, the remedial pathway is clear,” Chief Human Rights Commissioner Paul Hunt said. 

“Proactive, preventive alternatives, based on human rights and Te Tiriti and focused on de-escalation and trauma-informed practice, must be at the forefront.”

“Dr Shalev has identified that meaningful change will require a paradigm shift in seclusion and restraint practices in places of detention in New Zealand. We urge the New Zealand Government to prioritise the work required to catalyse this."

Click here to download the report.

Key findings

Overview

  • Seclusion and restraint practices are used too often, for too long, and frequently without a clear reason by agencies.
  • Data from agencies remains fragmented and disorganised.

Children

  • There has been a small reduction and more nuanced use of the ‘Secure Care’ room in a care and Protection residence, but in the Youth Justice facility it more than doubled, including 22 stays lasting 8 days or longer in a Secure Room during a six-month period in 2019.
  • The seclusion of children and young people is harmful to their health and wellbeing and can further traumatise them and damager their development and healing. 

Race and gender

  • The use of seclusion remains disproportionality high with Māori and Pacific Peoples across the board. In women’s prisons, for example, Māori women made up 78% of all stays in the most restrictive form of segregation (‘Management units’) in 2019 and were segregated for longer than European or Pacific women.
  • The discrepancy in the rate of segregation placements along racial lines may indicate unconscious bias in decision making.
  • Women were segregated at a far higher rate than men: 255 instances per every 100 women prisoners, compared to 147 instances per every 100 men prisoners.
  • Māori remain grossly over-represented in seclusion units. In the six months to March 2020, Māori made up 51% of the total number of people secluded in Health and Disability facilities. 

Use of force and restraint 

  • The data on the use of force and restraint provides a cause for concern across settings.
  • In health and disability facilities, for example, over a period of 6 months restraints were used 358 times, with 114 of these uses involving prone restraints (Holding a person face down on the floor or another surface), including several very lengthy holds – 1463 minutes in one case, 290, 125 and 100 minutes in others.
  • In prisons, substantial increase in use of restraint, mostly handcuffs from 423 over a six-month period in 2016, to 1488 over 12 months in 2019. Pepper spray was used 118 times. 

Recommendations

  • Stop the use of ‘Secure Care’ rooms for children and young people.
  • Reduce both the use and length of seclusion and restraint.
  • Explore potential racial and gender bias in decision making regarding seclusion/segregation.
  • Improve material conditions and access to meaningful human contact and activities in seclusion/segregation.
  • Provide therapeutic environments for distressed individuals and seek alternatives to seclusion and restraint for them.
  • Decommission facilities which are not fit for purpose.
  • Gather good quality and comprehensive data to monitor effective implementation of these recommendations.