Jess Cochran has been physically restrained, chemically sedated and held in seclusion at Victorian public hospitals more times than she'd care to remember.
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The first episode occurred at the age of 15, when she was locked up for weeks in the mental health unit at the Royal Children's Hospital, with severe anorexia, depression and anxiety.
It meant she was isolated in a tiny room with a mattress on the floor, and a small window looking out to a courtyard - an experience she says was confusing and terrifying.
Seclusion involves the sole confinement of a person to a space from which they can't escape, but under state law it should only be used as a last resort for psychiatric patients who are deemed a high risk to their own health or the safety of others.
However, as the Andrews government embarks on a royal commission into mental health, a damning new report obtained by The Age has revealed that the use of seclusion has risen in Victoria in recent years, with some hospitals breaching state guidelines and failing to meet key benchmarks designed to keep the practice at a minimum.
The report, by the Victorian Mental Illness Awareness Council and based on official data, also confirmed that Victoria secludes people at higher rates than Australia as a whole, with patients held in confinement for longer than in other states: an average of 8.3 hours last year (or double that when forensic services are taken into account) compared with a national average of 5.1 hours.
In 2014-15, Victoria had an average of 7.5 episodes of seclusion per 1000 bed days. The latest available figure, for 2017-18, is 9.1 episodes. Before 2014-15, Victorian rates had fallen every year since 2009.
Ballarat Health Services had the fifth highest rate of seclusion in the state in the last quarter of 2018 (October to December), with 20.1 episodes per 1000 bed days.
BHS acute operations director Ben Kelly said Ballarat had introduced a Department of Health and Human Services endorsed program (SAFE wards) to reduce the incidence of seclusion in recent months, and incidents of seclusion had fallen.
"In the longer term, as part of the Ballarat Base Hospital redevelopment, we look forward to modernised mental health facilities, once the works are completed," Mr Kelly said.
"These facilities will aim to provide more flexible and less restrictive care options seen in many of the newer mental health facilities, particularly in metropolitan areas.
"Seclusion is used as a last resort at BHS, in accordance with the legal requirements of Mental Health Act, and is only used when it is the only option available to keep both patients and staff safe."
Ms Cochran remembers that during her period of seclusion she became increasingly distressed as the hours passed at a glacial pace.
"They told me I wouldn't be able to leave until I ate everything that was put in front of me for two weeks," says the now 29-year-old.
"It's though you're some kind of rabid animal that needs to be put in a cage and controlled. And in the end it makes things worse, because you become quite fearful of seeking help down the track."
VMIAC human rights adviser Indigo Daya said the system clearly needed a shake-up, telling The Age, "there is no excuse for people to leave a state-funded mental health service feeling more emotionally traumatised than when they arrived."
Sometimes, too, the consequences are fatal. In NSW, hospitals were forced to overhaul their practices last year after a patient held in seclusion at Lismore Base Hospital died of brain injury in 2014, caused by falling numerous times and beating her head repeatedly on hard surfaces in the room.
Disturbing CCTV footage also showed the woman naked, drugged, and covered in faeces in the hours before she died, prompting an inquiry that exposed the entrenched discrimination and physical dangers involved.
NSW hospitals are now expected to reduce their use of seclusion to fewer than 5.1 episodes per 1000 bed days and ensure the average duration of seclusion is four hours.
Yet in Victoria, where the benchmark is 15 episodes per 1000 bed days, VMIAC's analysis found many hospitals can't even meet this target.
University Hospital in Geelong had the highest rate of seclusion in the last quarter of 2018 (October to December), with 36.5 episodes per 1000 bed days.
Wangaratta District Base Hospital had the second highest rate (32.5) followed by Box Hill Hospital (23.8) and Mildura Base Hospital (22.6).
By comparison, Casey Hospital in Berwick had a seclusion rate of 1.9 episodes in the quarter - the best rate in the state.
The issue is particularly sensitive for Premier Daniel Andrews, who made mental health a central plank of his pitch for re-election last year.
Asked about the latest data this week, Mental Health Minister Martin Foley conceded the issue "of seclusion and restraint is a serious one that needs to be addressed - and we can do better."
"We know that our mental health system needs repairing," he said "Patients churn through the system and fail to get the proper treatment they need, meaning they end up back where they started - and often sicker than they were in the first place. The royal commission will address that."