Patients in Shellharbour Hospital's acute mental health units were put in seclusion on 38 occasions from April to June - for around eight hours at a time - shocking new figures reveal.
Independent data from the Bureau of Health Information (BHI) shows a rise in seclusion events at the hospital compared to the same quarter in 2018, when 33 seclusion events were recorded.
It constituted a rate of seclusion of 11.4 (per 1000 bed days) for Shellharbour Hospital, which was the third highest in the state - behind Broken Hill (21.8) and Concord (11.9) hospitals.
And it was far higher than NSW Health's target rate of seclusion which is 5.1 per 1000 bed days for each hospital.
Patients also spent far longer in seclusion at the hospital - an average of seven hours and 50 minutes compared to the state average of five hours and seven minutes. NSW Health's target for seclusion is less than four hours.
Incidents of physical restraint also increased slightly at Shellharbour Hospital's acute mental health units - from 23 incidents in April to June 2018, to 25 in the same quarter this year.
The average length of time patients were physically restrained at the hospital was six minutes - above the state average of five minutes.
It's the first time the BHI's Healthcare Quarterly report has included instances of seclusion and restraint for the 46 public hospitals across the state with one or more specialised mental health inpatient units.
Shellharbour Hospital houses a range of units - including the 20-bed Eloura acute admission area; the six-bed Eloura high care area and the 20-bed Mirrabrook mental health unit.
Data was also recorded for Wollongong Hospital, which includes a 20-bed mental health unit. There were 13 seclusion events within that unit from April to June, and 10 incidents of physical restraint - both rates were under the state average.
According to the BHI report, seclusion and restraint is not therapeutic and involves the use of interventions to restrict the "freedom of movement" of a patient.
"Seclusion is where a patient is placed alone in a room; restraint is where freedom of movement is restricted," BHI senior director Hilary Rowell said.
"These are considered last resort practices and the aim is that the number and duration of both will fall over time."
Ms Rowell said the figures showed that across the state - and in the Illawarra - the majority of episodes of care in acute mental health units did not have a seclusion or physical restraint event.
"For instance we saw at Shellharbour Hospital 317 episodes of care in these units from April to June," she said. "Six per cent of those episodes had a seclusion event and five per cent had a restraint event.
"However there was a relatively high rate - and duration - of seclusion for Shellharbour compared to other hospitals, which they will be seeking to reduce over time.
"It's important to note though that each of these specialist units vary greatly in size, and the range of patients they look after, so it is difficult to easily compare them.
"What is important for the community is to see how each hospital tracks over time."
In May last year the NSW Government announced the targets to reduce the use of seclusion and restraint as part of a range of measures aimed at eliminating the restrictive practices.
The plan came after a damning review of the state's public mental health services, which was sparked after horrific CCTV emerged of a patient's final days at Lismore Base Hospital.
The footage showed Miriam Merten naked, drugged, disoriented and covered in faeces in the hours before she died of traumatic hypoxic brain injury on June 3, 2014, caused by numerous falls and beating her head against hard surfaces in a seclusion room.
Observation practices at Shellharbour Hospital's mental health facilities have also come under scrutiny in recent years.
Another patient Joseph Gumley was killed by his roommate Paul Hindmarsh at the Eloura West unit in 2014.
Meanwhile staff at the hospital's mental health units recently talked out about their safety fears, claiming several staff members had been assaulted by patients.
Illawarra Shoalhaven Local Health District executive director mental health, Caroline Langston, said she welcomed the inclusion of reporting on seclusion and restraint by the BHI.
"(The) district is committed to reducing and where possible, eliminating seclusion and restraint, and providing the best possible mental health care and treatment in the least restrictive environment," Ms Langston said.
"Staff working in our mental health facilities are focused on maintaining a safe environment for consumers, staff and visitors.
"Staff are trained to use therapeutic interventions and non-physical measures to prevent and manage situations of escalating aggression whenever it is safely possible.
"Restrictive practices, such as seclusion and restraint, are used as a last resort and with the least amount of restraint necessary to respond to the situation to keep both consumers and staff safe."
Ms Langston said $1.2 million was recently spent on improving the therapeutic environments of the mental health facilities at both Shellharbour and Wollongong hospitals.
"The mental health service continues to work with our staff and consumers to develop strategies, policies and resources to reduce the use of seclusion and restraint in line with the recommendations from the 2017 Review of seclusion, restraint and observation of consumers with a mental illness in NSW Health facilities."