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Mind calls for end to life-threatening face down restraint in mental health hospitals

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Posted on 18/06/2013

Mind pressures government to stop all face-down restraint.

Mind is today calling for the government and NHS England to put an end to life-threatening face down restraint of people with mental health problems in healthcare settings. Data secured by Mind under the Freedom of Information Act reveals that at least 3,439 patients in England were restrained in a face down position in 2011-12, despite the increased risk of death from this kind of restraint.

Shockingly, half of all face down restraint incidents occurred in just two trusts: Northumberland, Tyne and Wear NHS Foundation Trust and Southern Health NHS Foundation Trust. Yet two others - Hertfordshire Partnership University NHS Foundation Trust and Sheffield Health and Social Care NHS Foundation Trust - have already put an end to using face down restraint altogether.

There were at least 39,883 recorded incidents of all kinds of physical restraint during the 12 month period, resulting in at least 949 injuries to people with mental health problems. We found huge variation between mental health trusts in the use of all types of physical restraint. Surrey and Borders NHS Foundation Trust reported just 38 incidents over the year while Tees, Esk and Wear Valleys NHS Foundation Trust reported 3,346, despite the fact that physical restraint is supposed to be used as a last resort.

We also conducted a survey of 375 frontline healthcare staff involved in physically restraining people with mental health problems. Almost a quarter (22 per cent) had not had face-to-face training on physical restraint techniques in the last 12 months and one in ten (9 per cent) said that the last time they were involved in physically restraining someone, they didn’t feel they knew what they were doing. More than four in ten (42 per cent) said that, with hindsight, they feel restraint has sometimes been used inappropriately.

It was also evident that some healthcare professionals are using restraint as part of daily practice: some said they used it over 100 times in the last twelve months and others admitted that they use it every shift.

Paul Farmer, Chief Executive of Mind, said:

"Physical restraint can be humiliating, dangerous and even life-threatening and the huge variation in its use indicates that some trusts are using it too quickly.

Face down restraint, when a person is pinned face-down on the floor, is particularly dangerous, as well as extremely frightening to the person being restrained. It has no place in modern healthcare and its use must be ended. Our research shows that some trusts have a shameful overreliance on physical restraint and use face down physical restraint too readily in their response to managing a crisis situation.

We know that healthcare staff do a challenging job and sometimes need to make difficult decisions very quickly, but physical restraint should only be used as the last resort, when there’s no other way of stopping someone from doing themselves or others immediate harm. There is never an excuse for face down restraint.

When someone’s life comes crashing down in a crisis they need help, not harm. They may be frustrated, frightened and extremely distressed but even when they seem aggressive and threatening, or refuse treatment, they still desperately need help and compassion."

We’re calling for national standards on the use of restraint, accredited training and an end to face down restraint.

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