Report reveals concerns about restraint techniques used in Adelaide youth detention centre

"There would be staff coming from everywhere ready to jump on you."

"The workers that weren't even involved [in a restraint], like all the other workers from the units, would be standing around having a chat and laughing while you're there laying on the floor."

"Staff just kept on going. They kept on pushing my head into the ground."

These are the words of detained children and young people describing what it felt like to be forced into a restraint position by staff at the Kurlana Tapa Adelaide Youth Training Centre (AYTC).

The detention facility in Adelaide's north — which holds dozens of boys and girls aged between 10 and 18 — was this year subject to a joint inspection by Youth Training Centre Visitor Shona Reid and the state government's chief psychiatrist.

The inspection focused on the mental health and wellbeing of detainees, with the final report tabled in parliament on Tuesday.

The report found that "physical force and restraint" are "routinely" used at the centre.

This includes "prone restraint", where detainees are held on the floor in a face-down position.

In one instance, a detainee was in this position for 15-minutes, Ms Reid said.

The report found training centre staff were still using prone restraint despite "well-established risks including restraint asphyxia and its prohibition in child mental health settings".

"The continued use of prone restraint on children and young people is of serious concern, given its known risks and the fact that it is prohibited in child mental health care environments," the report states.

"Its use in AYTC may constitute a breach of human rights and clinical best practice."

Chief Psychiatrist Dr John Brayley said the use of prone restraint was among several "significant areas of concern" at the detention facility.

"Internationally, this is recognised as a very risky form of restraint," he said.

"It can lead to restraint asphyxia and potentially even death, so we do not believe that prone restraints should be used."

Prone restraint, according to the report, was used 24.6 per cent of the time to respond to an incident such as a threat, behavioural problem or assault to staff or youth.

The report found some restraint practices were "undocumented or fall outside approved techniques", raising concerns about "accountability, oversight, and safety".

Ms Reid said the technique was "really intensive" for children and young people.

"The use of restraints is something that's required in a facility, but it needs to be used carefully and cautiously," she said.

Mechanical restraints also used

The report reviewed 353 incident files between July 1, 2023, and June 30, 2024, that involved a total of 102 children and young people.

The report found that physical force — ranging from placing a hand on a young person's arm to escort them to their room, all the way to "highly restrictive restraints" — was used on 321 occasions.

This includes 114 times staff enforced a prone restraint.

On 84 occasions, mechanical restraints — including handcuffs, leg cuffs, closeting chains, leg wraps and padded helmets — were used, including when moving detainees around the facility.

The report found that "operational and staffing pressures" contributed to an "increasing reliance" on restrictive practices at the centre, rather than de-escalation.

Both the chief psychiatrist and the training centre visitor said staff were working to the best of their abilities under pressure. 

"The staff are really doing their best in really difficult circumstances," Ms Reid said.

"What we need is the system around our staff to support them better so they can actually hold the children and care for them in a way that we as a community expect that to happen."

Dr Brayley also said staffing shortages had hindered children and young people accessing mental health care at the centre.

"The mental health services are there, there's a clinic, but on many occasions children didn't make their appointment … because of operational constraints at the centre," he said.

"The clinical staff would then go to the units to … see children there, but that's not private in the same way as going to the clinic."

Minister will work through report's findings

Human Services Minister Nat Cook said the state government "values the work of the training centre visitor" and had responded to her report both in writing and in person.

The report makes five recommendations, including ending the use of prone restraint and developing detailed guidelines for physical and mechanical restraints, with "clear prohibition for use on children and young people in line with national and international standards".

It also called for establishing a 24/7 multidisciplinary health and mental health support team at the centre, finding the current mental health model at the centre was "fragmented, risk-gated, and unable to meet demand".

Ms Cook said reform to the "operational model" of the centre was ongoing and she would "continue engaging" with Ms Reid and other agencies to "work through the report's findings".

"The Malinauskas government is committed to enhancing and further embedding individualised, therapeutic, culturally safe and disability and trauma-informed approaches to service delivery at Kurlana Tapa [AYTC], underpinned by an evidence-based practice framework," she said in a statement.

"In addition to existing training and supervision, a range of key initiatives are underway to equip staff with the skills and knowledge to effectively respond to the needs of children and young people. 

"An enhanced support model of care is currently being finalised to better support young people with complex and disability-related needs."

Ms Reid said she was "really encouraged" by the department's response to her report.

"They have given indications around re-looking at their therapeutic care model, and that is encouraging," she said.

"But now it's time to see their words come to action."