Mental health fono spotlights high seclusion rates for Pasifika peoples

The high numbers of Pacific mental health and addiction (MHA) consumers who experience seclusion in DHB MHA in-patient services was one of the drivers behind a national Pasifika health fono held in May 2018.

The Health Quality & Safety Commission partnered with Le Va to deliver the Auckland fono for the Pasifika MHA community on 22 May. 

Pasifika consumers and family representatives joined MHA staff to talk about the issues associated with seclusion and to identify pathways for improving the safety and quality of MHA services for Pasifika communities.

Seclusion is recognised internationally as causing harm to those who receive it, and as contravening a person’s basic human (and disability) rights. Yet, while there have been huge advances in this area in New Zealand over the last nine years, thanks to the work of Te Pou o te Whakaaro Nui, the national key performance indicator (KPI) programme and frontline staff, Pasifika consumers of MHA services are still twice as likely to experience seclusion within in-patient units than New Zealand European or Asian consumers.

According to DHB inpatient data, 14 per cent of Pasifika consumers of MHA services were secluded one or more times, a similar rate to Māori (15 per cent), and double that experienced by New Zealand European and Asian consumers (7 and 6 per cent respectively).

The full-day fono provided a unique opportunity for attendees to discuss the practice of seclusion specific to Pasifika MHA consumers and the current practices within New Zealand.

It also enabled service users and family representatives to share personal and witnessed experiences of seclusion and promote a shared understanding of the trauma seclusion can cause to staff, as well as to consumers and their family members.

“It was really powerful to be able to present a Pasifika view on seclusion,” says the commission’s national consumer engagement advisor, Shaun McNeil. “It allowed us to have rich discussions about the real-life challenges facing the Pasifika mental health and addiction community. We were able to explore questions about safety and culture in depth and look together at opportunities to collaborate and create pathways to reduce the use of restrictive care that would work for the Pasifika community. Ultimately it’s about making care safer for all.”

The Auckland fono was part of the Zero Seclusion initiative; a national collaborative being led by the commission and Te Pou, in partnership with the national KPI programme and DHBs, to achieve the aspirational goal of eliminating seclusion in New Zealand MHA services by 2020.

The fono also provided an opportunity to introduce providers to the quality improvement methodology that underpins the commission’s MHA programme, and to discuss the opportunities for the commission to engage Pasifika peoples in its ongoing work, more effectively. This important event marked the first time the Pasifika MHA community, including consumers and family representatives, had come together to look at the issue of reducing seclusion from a purely Pasifika community angle.