Mentally ill patients were physically restrained 50 times at Shellharbour Hospital from April to June - double the number restrained in the same period in 2019.
And photos of a smashed-up glass door sent to the Mercury by a staff member - who did not wish to be identified - show that while restraint should be a last resort, it may sometimes be necessary.
"These are the kind of incidents staff at Shellharbour Hospital are exposed [to] on a regular basis," the staff member said. "This is [why] seclusion and restraint is increasing; the facilities are not up to standard."
The figures, revealed in a Bureau of Health Information (BHI) report, also show that patients in the hospital's mental health units were put in seclusion 65 times in the most recent quarter.
That was 38 more times than the same three months in 2019 and represented a seclusion rate of 16 (per 1000 bed days) - the fourth highest in the state. It was also well above the state target of less than 5.1 (per 1000 bed days).
However patients at Shellharbour Hospital spent far less time in seclusion than previously - an average of three hours and 44 minutes from April to June, 2020.
That was down significantly from the average seven hours and 50 minutes of seclusion recorded in 2019. It was also just below the state target of less than four hours.
Overall, the Healthcare Quarterly report revealed there were 403 acute mental health episodes of care at the hospital in the three months.
According to the BHI, a seclusion event occurs when a patient is placed alone in a room or an area at any time of day or night, with no freedom of exit.
A restraint event occurs when the patient's freedom of movement is restricted by physical means, such as the hands-on immobilisation by health care staff; or mechanical means through application of devices.
Illawarra Shoalhaven Local Health District Mental Health Director Julie Carter said the district was committed to reducing, and where possible eliminating, seclusion and restraint.
"Seclusion or restraint ... is only used as a last resort to keep both consumers and staff safe."ISLHD Mental Health Director Julie Carter
"The vast majority of acute mental health episodes of care are carried out without either seclusion or restraint, which is only used as a last resort to keep both consumers and staff safe," she said.
"The Mental Health Service has established an action group to develop and systematically implement a responsive plan focused on seclusion and restraint.
"Staff are also trained to use therapeutic interventions and non-physical measures to prevent and manage situations of escalating aggression whenever it is safe to do so and are constantly working on new ways to develop diversionary activities to care for consumers."
In NSW there are 46 public hospitals, plus the forensic hospital, with specialised acute mental health units that treat patients with varying severities of mental illness.
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.
Wollongong Hospital, which has a 20-bed mental health unit, had 288 acute mental health episodes of care from April to June. In that time, six patients were put in seclusion and 11 were physically restrained.
Yet Wollongong was one of 12 hospitals in NSW where the duration of seclusion was longer than four hours (four hours, 22 minutes).
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