Huge ethnic disparities surround the use of seclusion in adult mental health inpatient units in New Zealand, with Māori not only more likely to be secluded than non-Māori, but also, Māori have the highest crude population-based rate of seclusion events reported internationally (McLeod M et al. Te Pou o Te Whakaaro Nui. 2013). This qualitative study explored Māori clinical, cultural and consumer perspectives on potential strategies and initiatives considered likely to facilitate prevention of, and reduction in, the use of seclusion, with tāngata whai i te ora (Māori mental health service users) in mental health inpatient services. Sixteen people of Māori ethnicity, all of whom had high levels of clinical, cultural and consumer expertise, participated in a 2-day hui, which was recorded and transcribed. Thematic analysis revealed three key categories: Te Ao Māori (access to a Māori worldview); Te Ao Hurihuri (transforming practice); and Rangatiratanga (leadership, power, and control). The findings of this study align with the “Six Core Strategies” for best practice to reduce the use of seclusion (Huckshorn KA. Adm Policy Ment Health. 2006;33(4):482-91), with the overall aim of transforming treatment environments to minimise the occurrence of conflict and facilitate immediate resolution when conflict does occur. This paper concludes that a comprehensive approach to the reduction of the use of seclusion with tāngata whai i te ora is required, embedded within a Māori model of care and a vision for transformation of practice in mental health inpatient services and involving Māori leadership.
