KPIs for Australian Public Mental Health Services: PI 15 – Rate of seclusion, 2015–

Collection and usage attributes

Coverage/Scope:

• All public mental health service organisations admitted patient services.
• Services where seclusion is not an authorised practice under relevant mental health legislation and/or policy (such as non-gazetted admitted patient units that are not authorised to admit consumers on an involuntary basis) should be excluded (from numerator and denominator).

Methodology:

• This indicator is to be partitioned by the program type (i.e. acute and non-acute inpatient). Consequently, there would be two potential scores for this indicator. This partitioning will enable appropriate interpretation of the indicator and concept and facilitate accurate and targeted action to reduce the use of seclusion in mental health services. 
• Leave days should be excluded from the construction of the denominator.
• For the purpose of this indicator, when a mental health service organisation has more than one unit of a particular admitted patient care program, those units should be combined.

(Numerator ÷ Denominator) x 1,000

Number of seclusion events occurring in the mental health service organisation’s inpatient unit(s) during the reference period, partitioned by acute and non-acute inpatient mental health services.

Number of accrued mental health care days within the mental health service organisation’s inpatient unit(s) during the reference period, partitioned by acute and non-acute inpatient mental health services.

Service variables: Target population, program type

Consumer attributes: Age, SEIFA, remoteness, Indigenous status

Representational attributes

Indicator conceptual framework

Accountability attributes

Levels at which indicator can be useful for benchmarking:

• service unit
• mental health service organisation
• regional group of services
• state/territory.

There are no relevant data sets at the national level.

Seclusion data is not reported at the national level although patient days can be collected from either the Admitted Patient Mental Health Care or Mental Health Establishments National Minimum Data Sets.

No proxy solution is available. To construct this indicator at a national level requires separate indicator data to be provided individually by states and territories.

National collection of seclusion data needs to be established through amendments to the NMDS processes.

• The use of seclusion is governed by either legislation (a Mental Health Act or equivalent) or mandatory policy within each state and Territory. The definitions used within the legislation and policies vary slightly between jurisdictions. These variations should be recognised in the interpretation of the indicator.
• The duration of seclusion is an essential piece of information to align with an indicator of the rate or frequency of seclusion as it provides a better understanding of an organisation’s performance in relation to seclusion use and management. However, the capacity to collect information regarding duration of seclusion episodes varies substantially across jurisdictions. Work continues at a national level that will facilitate the development of a meaningful indicator of duration as it is likely to be easily skewed by outliers.

Source and reference attributes

Key Performance Indicators for Australian Public Mental Health Services, Third edition (2014)

Relational attributes