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Least restrictive practices

In 2014, we examined and reported on reforms for a more recovery-oriented and least restrictive approach in Queensland’s acute mental health wards, including locked wards.

We engaged The University of Melbourne to research least restrictive practices in acute mental health wards and examine consumer perspectives of acute mental health wards.

The university’s work informed the Commission’s Options for Reform: Moving towards a more recovery-oriented, least restrictive approach in acute mental health wards including locked wards (PDF, 518KB).

What is a recovery-oriented approach?

A recovery‐oriented approach is sensitive to the uniqueness and needs of each individual. It supports consumers to make their own choices and set their own goals, and gives opportunities for living a meaningful, satisfying and purposeful life as a contributing member of the community.

Least restrictive practices are essential to recovery. In terms of mental health wards, it’s about creating an environment that supports a person’s recovery and wellbeing, while preserving their dignity, rights and freedoms as much as possible.

Our report sets out options for reform that respond to local circumstances in Queensland’s acute mental health wards, and offer better outcomes for patients, hospital staff and the community.

The report supports flexible, localised decision-making by ward managers and clinicians around the needs of individual consumers in their care, rather than a one-size-fits-all approach.

Read the media release ’Reforms target mental health wards’.

Options for reform

The report outlined three core areas for reform:

  • supportive relationships
  • changing culture
  • ongoing monitoring and review of recovery-oriented practice.

Read the Options for Reform summary report (PDF, 769KB) for an overview of the key reforms.

The Department of Health, together with individual Hospital and Health Services are responsible for the day to day operations of the public health system.

2017 progress report

The 2017 progress report: Implementing recovery-oriented, least restrictive practices (PDF, 73KB) provides an overview of steps being taken by Queensland Health and Hospital and Health Services to implement a more recovery-oriented, least restrictive approach to mental health treatment.

It confirms the Commission’s position as outlined in the 2014 Options for Reform report, that:

  • the issue of locked wards is complex
  • acute mental health wards may need to be locked from time to time to ensure the safety of everyone on the ward, including consumers
  • decisions about locking wards should be made at the local level based on clear and objective criteria communicated to consumers.

Steps taken by Queensland Health and Hospital and Health Services include:

  • implementation of the new Mental Health Act 2016
  • the trial of the Safewards model in a number of HHSs
  • therapeutic leave arrangements in Mackay HHS.

The Commission will continue to monitor this issue closely and discuss progress with Queensland Health and other stakeholders including people with a lived experience.