Government considers banning ‘dangerous’ face-down restraint of mental health patients

The government is considering banning the use of face-down restraint in mental health services after campaigners revealed thousands of cases of the controversial practice being used on patients.

Data obtained by Mind from 54 mental health trusts in England revealed 3,439 cases of face-down restraint in 2011-12. The technique is “life-threatening” and traumatic for patients and should be ended, the charity said.

Health minister Norman Lamb said he was “very interested” in banning face-down restraint. “If that is possible, it should be done,” he told the BBC.

There was a “huge variation” in the use of face-down restraint in different parts of the country, said Mind.

While two mental health trusts had put an end to the practice, two other mental health trusts – Northumberland, Tyne and Wear NHS Foundation Trust and Southern Health NHS Foundation Trust – accounted for around half of all face-down restraint incidents.

In a statement Northumberland, Tyne and Wear NHS Foundation Trust said its staff are trained to manage episodes of violence and aggression in a “safe, supportive, dignified and professional manner” in line with national guidance.

“Due to the specialist nature of a number of our services such as our forensic services, the trust cares for some of the most complex and challenging patients from all over the country, which means that the figures may be higher when comparing to areas without such specialist services,” said the statement.

Southern Health NHS Foundation Trust said its staff its staff were trained to “use the most appropriate form of restraint in each case.”

Mind’s investigation also revealed at least 39,883 incidents where patients had been subject to any form of physical restraint in 2011-12, with 949 patients injured in the process.

A Mind survey of 375 frontline mental health professionals showed 40% felt that restraint had been used “inappropriately” in their service. Almost a quarter (22%) said they had not had face-to-face training in the use of physical restraint in the last year. 

Paul Farmer, chief executive of Mind, said that the disparity in the use of physical restraint in different parts of the country “indicates that some trusts are using it took 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 over-reliance on physical restraint and use face down physical restraint too readily in their response to managing a crisis situation,” said Farmer.

Rosemary Wilson, 66, said that the experience of being restrained while on a ward 11 years ago has had “a severe and enduring effect” on her mental health.

“Had it not been done under the Mental Health Act, it would have been assault. It has had a real impact on my self-esteem to be treated like an object and not a person,” said Wilson.