Restrictive Practice and the Harm Reduction Paradigm

The NSW Ministers for Health and  Mental Health commissioned an Expert Panel to undertake an independent review of Seclusion, Restraint and Observation practices in acute mental health services in May 2017.

The Ministers accepted all 19 recommendations in December 2017.  As a result, the NSW Ministry of Health has developed a plan: Mental Health Safety and Quality in NSW: A plan to implement recommendations of the Review of seclusion, restraint and observation of consumers with a mental illness in NSW Health facilities”.

This keynote describes the implementation process and its governance, and explores the relevance of a wider reform of patient safety and harm reduction, and the relationship between elimination of restrictive practice, improvement science, and other harm reduction imperatives for mental health services.


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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