An Auckland mental health clinic has been found by the Ombudsman to still use painful restraint techniques on patients who suffer from intellectual disabilities.

Chief Ombudsman, Peter Boshier inspected the Mason Clinic’s Pohutukawa Forensic Intellectual Disability Unit in Auckland.

He found that the clinic was still using dangerous restraint techniques which include wrist locks and prone (floor) restraints, which he says is "unacceptable".

These techniques are when a staff member uses their body to control a patient on the ground if they become a danger to others. They have been largely rejected by mental health professionals as they can have a significant effect on the person's physical and mental health.

Boshier released a report on Thursday making 11 recommendations to unit management and Waitematā District Health Board.

Eight of the recommendations were accepted while three were rejected, including the recommendation to cease using wrist locks and floor restraints.

The Mason Clinic believe that these kinds of restraints are the most effective when dealing with a person who poses a significant threat.

According to Boshier the Mason Clinic is one of the last facilities in New Zealand to use these techniques.

"The service says the use of wrist locks, which can cause pain, and prone (floor) restraint, in which the care recipients are restrained with a staff member’s body, are the most effective way of establishing and maintaining a safe environment.

"I understand that some individuals have challenging behaviour but there are other de-escalation techniques and methods available that would reduce the risk of pain for care recipients," Boshier says.

He is calling for the clinic to start operating in line with human rights standards.

"The clinic’s own policy states that the use of wrist locks and prone restraints will be eliminated by 2020. But they were still being used in April 2021. This is not good enough. At the very least the clinic should implement its own policy to ensure that restraint training aligns with human rights standards."

In his inspection, Boshier also noted that female care recipients were often unable to be accommodated and sent to other units at the clinic.

Senior management told the Ombudsman that women at the clinic were placed in other units due to capacity issues and to protect them from “significant risk” posed by male care recipients.

As a result of these moves, women are being treated for mental health, not intellectual disability care.

"In my view, it is inappropriate for care recipients to be placed in other units due to operational and environmental constraints within the service. I will be monitoring this in future inspections," Boshier says.

In a statement Te Whatu Ora-Health New Zealand Waitematā say it is "fully committed to providing safe and secure treatment facilities for users of our Mason Clinic-based Pōhutukawa Forensic Intellectual Disability Unit".

They say the unit provides assessment, care and rehabilitation for people with intellectual disabilities who have committed a criminal offence. All of whom require a medium-secure (or higher) level of care.

"Consequently, every effort must be taken to ensure the highest possible levels of safety for service-users and staff alike.

"The Ombudsman’s report acknowledges the therapeutic approach to calming service-users within the unit using sensory items, activities and the provision of cultural support. These methods, part of good clinical care and consistent with Safe Practice and Effective Communication (SPEC) techniques, are very effective in many circumstances and it is pleasing to see their use acknowledged.

"We do not consider SPEC techniques to be robust enough to ensure the high level of safety we require in a forensic setting with this particular cohort of individuals.

"Used sparingly and by professionally trained staff, the use of wrist locks and prone (floor) restraints are, therefore, sometimes necessary in especially volatile situations where service-users are likely to harm themselves or others.

"We are working with the SPEC National Governance Group on additional training options for these exceptional circumstances and our combined efforts in this area will provide valuable guidance around the use of wrist lock and prone floor restraints in the future.

"The Ombudsman also makes reference to the “placement of care recipients, particularly female recipients, in other units across the wider forensic service.

"The number of specialist hospital-level beds across the country is currently insufficient to meet the demand for this type of care and we have made five beds in other mental health units at Mason Clinic temporarily available to help alleviate the shortage.

"Every care is taken to ensure these services-users are in an environment that is most likely to result in positive outcomes."