Rising number of mental health patients restrained
THE number of mental health patients being physically restrained in Kirklees is on the rise – with people held face-down, sedated, or even tied up.
NHS figures show that there were 135 people in the district who underwent what’s known as a “restrictive intervention” in 2017/18.
This is when a person is physically restrained by staff in an attempt to control a potentially dangerous situation.
The 135 people restrained in 2017/18 is up from 120 the previous year.
The figure includes both adult and child patients who had been accessing secondary mental health, learning disabilities and autism services at the time.
A person can be restrained more than once, however.
Across 2017/18, there were 755 counts of restrictive intervention used in Kirklees - meaning each of the 135 patients was physically restrained an average of six times throughout the year.
A person can experience more than one type of restraint.
Some 55 people were held face down at least once in what is known as “prone” restraint.
A further 115 were physically restrained without being held face down. Some 25 people were given chemical sedation at least once in the year, and five people in Kirklees were mechanically restrained.
This type of restraint known to be used nationwide include strapping people in wheelchairs, handcuffing patients, and using a heavy table to stop a person getting out of their chair.
Kirklees health chiefs have denied that anyone has been tied to a wheelchair.
A further 10 individuals were secluded, which is a person is removed from a situation.
Carol Harris, Director of Operations at South West Yorkshire Partnership NHS Foundation Trust, the provider of mental health services in Kirklees, said: “We aim to ensure that least restrictive practice is observed at all times.
“Regrettably, there are times when physical restraint has to be used where there is a need to take immediate control of a dangerous situation, to make sure people stay safe.
“We try very hard to avoid using any sort of restraint and prefer to try to talk with someone who is agitated or provide an environment that would support them to feel more relaxed.
“Unfortunately there are times when restraint is necessary to maintain the safety of the individual and of other people.
“Restraint can include a range of actions from putting a hand on someone’s arm to completely restricting their movements by holding them.
“We only use restraint when all other attempts to keep the person safe haven’t worked and we use it for the shortest possible time.
“We make sure that any interventions employed to manage behaviour is justifiable, appropriate, reasonable and proportionate.
“In recent years we have taken measures to improve the safety of our patients and staff and we have noticed a significant reduction in the number of restraints we have had to use.
“Prone restraint means that the person would be held face down. We are working hard to eliminate all prone restraints but there are still times when the staff feel it is the safest option for a few moments to then allow a bet- ter position to be found.
“We recognise the risks involved in doing this for a prolonged time and for this reason we report every incident of prone restraint to our Trust Board.
“Mechanical restraint is very rarely used and it is so exceptional that we would seek the permission of the most senior clinician before considering its use.”
Alex Kennedy, head of campaigns and public affairs at Rethink Mental Illness, said: “Although we should be cautious about inter- preting trends as it is only the second year that data has been published, we know that restraint is used far too often, when it should be a last resort.”
The passing of Seni’s Law - named after a young man who died in 2010 after being held face down - should mean that we have better data and policies on restraint in the future.
“We hope that better understanding will lead to a greater focus on de-escalation being used instead of force.
“There are also wider issues that need to be tackled. The recommendations of the recent Independent Review of the Mental Health Act call for less coercion and more involvement of patients in mental health hospitals. We are calling on the Government to accept the Review’s proposals in full.”
Meanwhile, 75 people in Calderdale were physically restrained in 2017/18 - up from 70 the previous year. The situation reflects the national trend. Across England, 10,028 people were physically restrained in 2017/18 - up from 9,771 the previous year.
There were a total 99,609 occasions when a person was restrained - an average of 10 times in the year for each of the 10,028 patients. NICE guidelines say that restrictive interventions must only be undertaken in a way that complies with the Human Rights Act.
The guidelines also say that an post-incident debrief must conducted immediately after a restrictive intervention has taken place.
Trust boards or governing bodies should also be given regular reports from each ward about violent incidents, the use of restrictive interventions, service users’ experience of those interventions and the learning gained.