Dr Bill Lu, Dr Claudia Kaye, Dr Krishna Pillai1
1Auckland Regional Forensic Psychiatry Service, New Zealand
Biography:
Dr Bill Lu is a senior psychiatry registrar with Health New Zealand Waitematā and Chief Registrar within the Northern Region training scheme. He brings a multidisciplinary background spanning psychiatry, pharmacology, military service, and health governance. Dr Lu held academic appointments with the University of Otago as an Honorary Clinical Lecturer and Research Assistant in Psychological Medicine. He also serves on the Binational Faculty of Consultation-Liaison Psychiatry of the RANZCP and is an appointed member of the Lottery Health Research Committee.
Reduction of restrictive practices (RP) is a key challenge for modern forensic mental health services which must provide therapeutic spaces at higher levels of security while upholding the human rights and dignity of those detained. The literature on reducing RP has focused on patient characteristics, staff training and care processes. However, a growing literature has highlighted that physical design features may reduce triggers for aggression and subsequent RP. This study leverages phased redevelopment across a forensic mental health campus to compare rates of environmental restraint (a RP) between older units and new facilities built to Australasian Health Facility Guidelines (AHFG) standards. A retrospective observational study design is utilised comparing RP across four medium-secure units (two legacy: pre-2000; two AHFG-compliant: built 2017/2021). Preliminary results show lower rates of environmental restraint use in the newer facilities. Implications for the next phase of redevelopment and contemporary forensic mental health facility design are discussed.