A recent Irish News report has brought a deeply concerning set of figures into public view: 162 incidents of seclusion involving mental health patients were recorded across Northern Ireland in 2025, with 106 occurring in the Southern Health and Social Care Trust. More than 65% occurred at the Bluestone Unit.

Credit to Diane Dodds MLA for asking the questions that brought this information to light. But the response to her questions from both the Southern Trust and the Department of Health raise far more questions than they answer.

The Department of Health’s 2023 Regional Policy on Use of Restrictive Practice in Health and Social Care makes clear that seclusion is a highly restrictive practice that should only be used as a measure of last resort, when all other interventions have been exhausted and there is a presenting risk to the person or to others. So when one Trust accounts for almost two-thirds of all reported incidents — and one unit accounts for 65% — the public are entitled to know why and to know what steps are being taken to urgently address this.

This is also an important test of the Department of Health’s newly launched Being Open Framework, published in February 2026. The Framework promises a culture of “openness, honesty and transparency” across Health and Social Care, including routine openness, continuous learning, and openness when things go wrong. Yet if the system cannot explain why restrictive practices are so concentrated in one Trust and one unit, the Framework risks becoming a statement of aspiration rather than a mechanism for accountability.

Questions from New Script the Southern Trust

• 106 incidents does not necessarily mean 106 people. How many individual people experienced seclusion in 2025, and how many experienced it repeatedly?

• How long did each period of seclusion last? What reasons were recorded, and what alternatives were attempted first?

• Why did Bluestone account for such a high proportion of incidents?

• What were staffing levels, vacancies and agency staffing levels at the time?

• And what happened afterwards? Were people offered meaningful debriefs? Were their experiences recorded? What learning resulted — and what changed?

• The Trust is now within the scope of the Being Open Framework. When will it publish its Being Open policy and demonstrate how these incidents are informing learning and improvement?

Questions for RQIA

• Has RQIA independently reviewed the concentration of seclusion incidents within the Southern Trust and Bluestone? If not, will it now?

• What assurance has RQIA received that seclusion is genuinely being used as a last resort?

• Will it examine whether people’s experiences, including those subjected to repeated seclusion, are informing improvement?

Questions for the Department of Health

Following the publication of the Muckamore Inquiry report in June 2026, the Health Minister Mr. Mike Nesbitt MLA told HSC leaders that responsibility for ensuring the safety and quality of care delivered within their organisations rests with them and their Boards.

• What is the Department of Health’s response to these figures?

• Why did incidents fall to 13 in 2024 and then rise so sharply in 2025?

• What is the data for 2026 indicating to date?

• And most importantly: how will the Department use the Being Open Framework to ensure that these figures trigger transparency, scrutiny, learning, and action — rather than simply another set of statistics?

If “being open” means anything, this is the moment to demonstrate it.