Chief Ombudsman Peter Boshier is concerned that seclusion settings at forensic units in the Wellington region are "not fit for purpose".
Today he published four reports following inspections of Haumietiketike intellectual disability forensic unit and three forensic mental health facilities at Capital and Coast District Health Board (CCDHB) Rātonga-Rua-O-Porirua Mental Health Campus in July 2020.
The other three reports cover Rangipapa Forensic Acute Mental Health Unit, Tāwhirimātea Forensic Rehabilitation Unit and Pūrehurehu Forensic Acute Mental Health Unit.
Issues raised in the four reports include clients sleeping in hallways and inequitable treatment of female clients at one of the facilities.
"These findings are of immense concern to me and I have again raised my specific concerns directly with the CEO of the DHB. I will continue raising these issues through my inspections and reports with the Ministry of Health and CCDHB," Boshier said.
The inspections were carried out under the Crimes of Torture Act 1989. New Zealand is a signatory to the Optional Protocol to the Convention Against Torture, an international human rights agreement.
"While some of the conditions I have serious concerns about can be attributed to poor design or a lack of investment in infrastructure, others cannot," Boshier said.
In the report of a surprise inspection of Haumietiketike Unit, an intellectually disabled client 'Client A' was said to have been identified as living permanently in seclusion in earlier Ombudsman reports of 2014 and 2018.
"In 2014 my predecessor reported on Client A's living conditions, with recommendations for change. During my inspection in 2017 I found Client A was still living in the same de-escalation bedroom they had been in for about five and a half," Boshier said.
When the 2020 inspection was carried out, it was found that Client A was still living in the room. It was noted that the only face to face contact with staff or other clients was through a wired fence.
"I am disappointed that Client A was still living in conditions which I regard as cruel and inhuman treatment and could amount to a breach of Article 16 of the Optional Protocol to the Convention Against Torture (OPCAT)," Boshier said.
Following the 2020 inspection, Client A was moved to new accommodation.
"Their living area was more attractive and spacious, there was an activities room, and the use of a restraint belt means they could have contact with staff," Boshier said after a visit in February 2021.
"However, while I acknowledge the progress made in the care of Client A, they were, as of February, still effectively in seclusion. They remained alone, in a locked area, unable to leave. If they needed to use the bathroom at night, then staff need to be called.
"Client A remained in conditions that are not fit for purpose. While I acknowledge CCDHB considers it is following Ministry of Health guidelines, this treatment clearly meets the definition of seclusion and should be understood as such," Boshier said.
He said more needed to be done for the disabled client who had been living in effective seclusion for years.