Dear Health New Zealand,

Can you please provide information regarding uniforms for nurses (registered, enrolled etc) and mental health assistants/psychiatric assistants working within Forensic mental health inpatient environments. Including, but not limited to, high, medium and low security wards (e.g. Lock, Unlocked, or transitional wards).

Area that may be included, but not restricted to
- Mason clinic
- Henry Rongomau Bennett Centre/Puawai Forensic services
- Stanford house
- Ratonga-Rua-o-Porirua
- Hillmorton
- Wakari
Or any other mental health units under health NZ providing forensic mental health support.

please outline each ward if uniform varies (as different acutity wards may require different uniform).

Please outline which areas/wards have a specific uniform, if so what, or if RNs/MHAs wear civies (e.g. Normal clothing without branded or identification to maintain patient privacy and reduce power imbalance between staff and patient for therapeutic purposes).

Any further questions in relation to the request please pass them on

Yours faithfully,
G.R

Kia ora

Thank you for your response and time,

The reply states that the uniform programme is driven by staff comfort, ease of supply, clear professional identification, positive patient experiences, and national consistency, while also noting that decisions regarding uniforms versus civvies in forensic mental health settings are made locally.

However, the information provided identifies only one region where uniforms are compulsory. I would appreciate clarification on how this aligns with the stated intent of national consistency and if this will be reviewed with the role out of new uniforms.

If national consistency is a key rationale, please clarify why Waikato forensic mental health staff are from 2024 were longer permitted to wear civvies, while other regions continue to retain this option, and how this aligns with the statement that uniform decisions are made locally.

Further, during the 2024 Waikato region mental health compulsory inpatient uniform rollout, community-based staff were permitted to continue wearing civvies (with the option of wearing uniforms), while inpatient forensic wards were made compulsory - only with further consultation secondary from push back from unions. Staff who frequent public areas with patients were required to wear compulsory unbranded uniforms - however there’s are still very identifiable in large groups. Please confirm whether this reflects current policy and uniform rollout rationals, having differentiation between service types within the same region.

Additional clarification is requested in relation to the following:

* Cost: Whether cost efficiency considerations include any analysis comparing full uniform provision versus maintaining civvies as an option. As allowing civvies, or reintroducing civvies during the may uniform roll out in the Waikato area as an option would likely reduce uniform-related costs.

* Consistency: Whether there is a defined national or local dress code policy for civvies, and whether this is considered an alternative mechanism for achieving consistency. A clear dress code for civvies could achieve consistency without removing flexibility. (Some NGOs that have civvies have policies standing what colours staff can wear, if role identification is a concern, or more identifiable ID cards seen overseas - large font RN; EN; MHA)
* Staff feedback: What formal processes exist for staff to raise concerns regarding uniform design and implementation, including feedback on current issues such as material, visibility, and comfort. Multiple Waikato staff have raised concerns about the new uniforms, particularly the unbranded bright synthetic polos, with limited evidence of these concerns being meaningfully addressed. Please advise what formal pathways exist for escalation.
* Patient experience: How the use of uniforms versus civvies in mental health inpatient and community settings has been assessed in relation to therapeutic engagement, power dynamics, and patient privacy. Non-uniform approaches are widely recognised in mental health settings as supporting therapeutic relationships and reducing power imbalance. In community settings, uniformed groups may also inadvertently identify individuals as patients, impacting privacy and dignity.

Please also clarify:

* Whether Waikato’s policy regarding compulsory forensic mental health uniforms will be reviewed to align with the stated objectives of the may uniform role out : ease of supply, cost-effectiveness, staff comfort, patient experience, and national consistency

* Whether there are any plans to introduce a nationally consistent approach that includes the option of civvies in mental health settings where clinically appropriate

Thank you again for your time to read through and respond,
Ngaa mihi nui

Grace. R.