Six years of national mental health seclusion data: the Australian experience

Objectives: Reducing or eliminating seclusion from mental health care settings has been a national priority for Australia since 2005. This paper describes Australia’s national seclusion data collection, and summarises changes in seclusion rates in Australian public mental health services. Methods: Seclusion events per 1000 patient days were calculated from 2009–2010 to 2014–2015 utilising state and territory administrative data sources. Combined national data were used to calculate results for a number of service characteristics, such as target population and location of the service. Results: The rate of seclusion events decreased by 43% over the 6 years. Child and adolescent services reported consistently higher rates of seclusion, but a shorter duration of seclusion episodes, compared with other service types. There is high variation in seclusion rates between individual services (range 0.0–53.0 seclusion events per 1000 bed days in 2014–2015). Conclusions: Seclusion event rates in Australia’s specialised public acute mental health hospital services are declining. The use of existing administrative data was instrumental in establishing a national data source to facilitate the monitoring and reporting of progress of seclusion reduction strategies.