Building collaborative cultures of care

within NSW mental health services

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Governance systems

Governance systems, accountability and processes sustain and improve high-quality care.

In practice

  • Having structured internal audit and reporting systems (see Leadership).
  • Recording and reviewing all instances of restraint and seclusion as soon as possible, to prevent or minimise future restraint.
  • Informing executive level staff about incidents immediately as they arise.
  • Establishing and adhering to clear debriefing processes for staff (three-tier: immediate, delayed and senior review; post hoc debrief and incident debrief following restrictive intervention) and considering collaborative debriefs with the person with lived experience.
  • Practising debriefing through simulation training.
  • Ensuring there is cultural awareness and recognition of the effects of previous trauma on the experience of restrictive practices.
  • Reporting on restraint and seclusion rates and improvement activities in public spaces.
  • Modelling excellent behaviours when services and staff adopt guidelines and to share what worked well or didn’t across services.


Consumer peer worker post seclusion collaborative review

Implementation of a post incident review in collaboration with consumer, peer workers and clinicians. Post seclusion event briefing - to understand what took place proceeding, during and following the intervention.


Establishment of the mental health co-design committee

A committee was established to improve the therapeutic environment using a co-design approach with consumers and carers to reduce and where possible eliminate seclusion and restraint.


Post hot debrief and incident review

A hot debrief is a lessons learned review carried out immediately after the event to ensure all feedback, outcomes and actions required are obtained before anyone leaves.