to sustain appropriate support for young people with respect to their disability support needs. Inspectors encountered a 15-year-old being managed in an adult secure home due to the lack of appropriate youth facilities. The lack of appropriate youth beds has brought about an inappropriate default to the mental health and criminal justice pathways to find a solution for some youngsters. Inspectors noted several 16 and 17-year olds being managed in acute mental health units due to the lack of secure youth beds. While there were measures put in place to mitigate the risks for the youth (line of sight supervision), the mixing of youth and adults is a breach of the United Nations Convention on the Rights of the Child. As well as raising our concerns at the time of the inspection, ongoing discussions are being held with the National Manager for Intellectual Disability and A question of restraint A thematic inspection into the care and management of prisoners at risk of self-harm or suicide found that the use of restraints on five prisoners amounted to cruel, inhuman or degrading treatment. In March 2017 Chief Ombudsman Peter Boshier published our first thematic OPCAT report A Question of Restraint, about the use of seclusion and restraint in five At-Risk Units in New Zealand prisons. Some jurisdictions that have ratified OPCAT have banned the use of tie-down beds. The Chief Ombudsman found that the Department of Corrections had breached Article 16 of the United Nations Convention Against Torture in its use of restraints on five prisoners. One prisoner was tied to a bed for 37 consecutive nights, the period of his restraint coinciding with reduced staffing; another was kept in a waist restraint with his hands cuffed behind his back for 12 weeks, the cuffs being removed every two hours during the day and every four hours at night. The Chief Ombudsman also found that monitoring At-Risk Units at all times by a live camera feed, the Children’s Commissioner to find a workable solution. Mental Health (Compulsory Assessment and Treatment) Act Similar to last year, Inspectors observed an increase in pressure on acute admission beds with dayrooms, offices, and seclusion rooms routinely being used as bedrooms. The effect of high occupancy levels was having a detrimental effect on the health of staff and service users as well as reducing staff ability to provide optimal nursing care. The risks associated with high occupancy levels has resulted in an increase in restrictions for all service users, including voluntary clients. Service users reported to the Inspectors that the environmental restrictions (locked doors), and lack of autonomy adversely affected their experience of the Service. Inspectors also noted evidence of including when prisoners were abluting, was degrading treatment under the Convention Against Torture. Other concerns included a lack of mental health training for Corrections staff, limited interaction or therapeutic activities for prisoners isolated in At-Risk Units, poor record keeping, and limited staff training. In response to the report, Corrections has started a review of its practice in At-Risk Units and we will monitor progress. Our OPCAT team also supported international human rights expert Dr Sharon Shalev when she visited New Zealand in late 2016 at the invitation of the Human Rights Commission to consider seclusion and restraint practices in prisons, health and disability units, youth justice and care and protection residences. Dr Shalev’s report Thinking Outside the Box recommended New Zealand eliminate the use of mechanical restraints altogether. A Question of Restraint is available at www.ombudsman.parliament.nz Thinking Outside the Box is available at www.seclusionandrestraint.co.nz 19