"Seclusion Episode – Factual Recount (WA Health–Aligned)"

Context

•The patient was an involuntary inpatient detained under the Mental Health Act 2014 (WA).

•At the time of seclusion, the patient was assessed as experiencing acute distress with suicidal ideation, placing them in a high-risk category requiring enhanced monitoring.

Seclusion Conditions

•The patient was placed in a designated seclusion room.

•The room did not contain toilet or handwashing facilities, requiring staff-facilitated access to meet basic needs.

•Seclusion occurred during the night shift.

Observation and Monitoring

•While secluded, the patient activated the call/buzzer system on multiple occasions.

•Calls were routed to nursing staff.

•In patient's opinion, no timely response to call activations was observed.

•Patient understanding is this is inconsistent with WA Health requirements for continuous observation, regular engagement, and responsiveness during seclusion, particularly for high-risk patients.

Access to Basic Needs

•During seclusion, the patient requested:

•Access to toilet facilities

•Drinking water

•Food

•These requests were not actioned within what the patient believes to be a reasonable or clinically appropriate timeframe.

•No alternative toileting measures (e.g. escorted bathroom access, bedpan, continence aids) were provided, contrary to standards requiring maintenance of basic physiological needs and dignity.

Hygiene and Dignity

•Due to the absence of toileting access and lack of staff response, the patient urinated and defecated on the mattress in the seclusion room.

•The patient remained in the room without immediate hygiene intervention, cleaning, or mattress replacement.

•The patient subsequently fell asleep on the soiled mattress, indicating a failure to uphold minimum dignity, infection control, and care standards.

Staff Conduct and Engagement

•During the seclusion period, nursing staff were observed:

•Using mobile phones

•Remaining seemingly inactive when not responding to clinical tasks

•No proactive welfare checks, de-escalation, or preventative engagement were observed, inconsistent with WA Health guidance that seclusion be actively managed, time-limited, and regularly reviewed.

Outcome

•The patient remained detained under the Mental Health Act following the seclusion episode.

•No immediate corrective action addressing hygiene, toileting access, or monitoring deficits was observed during the seclusion period described.