Zero seclusion: Safety and dignity for all

Seclusion is the practice of placing a mental health consumer in a room from which they cannot exit freely.

In mental health and addiction (MHA) services, people who arrive in an acutely distressed state are sometimes put into seclusion as a last resort. Seclusion is traumatic and harmful for consumers, whānau, visitors and health workers alike.

The elimination of seclusion in mental health has been government policy for over a decade.

Zero seclusion: Safety and dignity for all project

The Zero seclusion: Safety and dignity for all | Aukatia te noho punanga: Noho haumanu, tū rangatira mō te tokomaha project has been underway since 2019.

The Programme aims to reduce seclusion rates in both Māori and non-Māori/non-Pacific population groups in mental health and addiction adult unit inpatient settings to less than 3 percent by 1 June 2025, working towards the goal of health equity and ultimately zero seclusion.

A change package is available here for use by zero seclusion project teams as they plan, design, test and apply evidence-informed practices in their local environments. It comprises a clinical bundle (clinical change ideas), a cultural kete (mātauranga Māori approaches and interventions) and a consumer kit (change ideas and strategies including insights from those with lived experiences).

Alternatives to seclusion 

Te Tāhū Hauora works collaboratively with the Ministry of Health, Te Pou and health district project teams to assist health district mental health facility staff, excluding forensic facilities, find alternatives to seclusion.

Thanks to the work of Te Pou, we have evidence that approaches showing promise include engaging well with the individual and the family and whānau, peer support and sensory modulation, among others.

For example, effective ways staff can support people in distress include:

• placing consumers in a quiet space
• actively listening to their concerns and needs
• learning about what happened before the consumer arrived at the facility
• identifying triggers and what could calm a consumer
• offering food or a drink
• if the consumer wishes, ensuring whānau are involved early on and throughout the time the consumer is in the facility.

Find out more about how project team members and Te Pou collaborate on the Zero seclusion project here.

Further resources

• Zero seclusion case studies: How DHBs are successfully reducing the use of seclusion

• National decrease in seclusion rates in inpatient mental health units – particularly among Māori and Pacific peoples

• Auckland District Health Board shows zero seclusion is both possible and sustainable