Restraint and Seclusion: A Lived Experience

In 1853 a new prison was built in Tasmania. Based on the English Pentonville Prison, the facility used prisoner separation and moral therapy principles of silence, solitude, and prayer rather than corporal punishment. John Lane, an ancestor of the author, could not cope with the extreme sensory deprivation and went insane. What started as an experiment in prison reform became one of psychological torture.

One hundred years later the Lachlan Park Hospital, under the eugenics based Mental Deficiency Act (1920) became a prison for anyone society deemed undesirable; the author’s grandmother among them. The restrictive practices employed by the hospital were inhumane, even by the standards of the day.

In 1968 Lachlan Park became the Royal Derwent Hospital, but little else changed, except this time the author was the one being detained. Mechanical, chemical and physical restraint were freely used, as was seclusion. A more humane Mental Health Act, based on United Nations human rights principles, was introduced in 1999, but was soon replaced by the Mental Health Act (2013), which reinstated some restrictive practices considered by the author as dangerous and obsolete.

Like a Progressive Barn Dance, Tasmania has in some respects gone full circle and returned to the 1850s, with many acknowledging the need to eliminate restrictive practices from psychiatric settings but facing resistance because many remain unsure of the consequences of what would be a radical departure from decades of established practices.

TERP FORUM

TERP focuses on identifying, avoiding and reducing harm across all environments in which the care of people with mental ill health is provided. TERP inforces Australia’s commitment to reduce the use of, and eliminate restrictive practices as a priority for action. Each jurisdiction, in conjunction with the Safety and Quality Partnership Standing Committee and the Commonwealth Government, works towards this vision by holding a series of forums providing an opportunity to learn and grow from local and national initiatives to eliminate restrictive practices and create a dialogue for future care.

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