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Face-down restraint use widespread against women and girls

Thursday, 02 March 2017 Mind

Vulnerable women and girls are being repeatedly restrained in the face-down position in mental health units, according to new figures from Agenda, the alliance for women and girls at risk.

The research from Agenda found that girls admitted to Child and Adolescent Mental Health Services (CAMHS) in England were more likely to be restrained face-down than boys. Adult women patients were more likely than men to be repeatedly restrained face-down.

The findings also show that other forms of physical restraint were widespread – with one in five women and girls having been restrained. In some trusts this figure was as high as three quarters. This is despite the fact that more than half of women who have mental health problems have experienced abuse. So not only is being restrained frightening and humiliating it also risks re-traumatising women and girls.

Agenda is today calling for an end to the use of face-down restraint, which can also be physically dangerous, and for other forms of restraint to only ever be a last resort. The alliance instead wants women and girls’ particular needs, including their history of trauma, taken into account in mental health services.

The alliance’s research – as part of its Women in Mind mental health campaign - showed that:

  • Girls were restrained face-down more than boys (180 girls – or 8.1% of female patients – versus 72 boys, just 5.7% of male patients).
  • Girls were restrained face-down nearly 2,300 times, compared with fewer than 300 incidents of boys being restrained in this way.
  • Girls were more likely to be restrained face-down repeatedly – with some trusts reporting an average of more than a dozen face-down restraints per female patient.
  • In adult services, more than 6% of women (nearly 2,000) were restrained face-down more than 4,000 times.

Figures obtained by Freedom of Information request for FY2014/15


The figures also exposed the huge regional variations in the use of face-down restraint, with some trusts using it very little or not at all, while some used both physical and face-down restraint on a regular basis.


Katharine Sacks-Jones, Director of Agenda, says:

“It is alarming and unacceptable that women and girls are regularly and repeatedly restrained in mental health settings.

 “Not only is being restrained frightening and humiliating, it also risks re-traumatising those with a history of abuse. Mental health units are meant to be caring, therapeutic environments for women and girls feeling at their most vulnerable, not places where physical force is routine.”

 “Restraint should only ever be a last resort and face-down restraint is an out-dated practice which should not be used at all. Instead women and girls’ needs, including their history of trauma, should be taken into account in mental health services.”

Mental health charity Mind first exposed the widespread use of face-down restraint in their report ‘Mental health crisis care: Physical restraint in crisis’ in 2013. Today they backed Agenda’s call for action.

Paul Farmer, Chief Executive of Mind, says:

“Agenda’s research shows that some trusts have a shameful over-reliance 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.”


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