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Is physical restraint over-used?

  • Comments (19)

Nearly 40,000 incidents of physical restraint on mental health patients in England were recorded in one year - with more than 3,000 in the “dangerous” face-down position - according to figures released by Mind.

Worryingly, a separate survey of 375 frontline workers by Mind found that 22% of staff involved in restraints had not had restraint update training in the past 12 months.

More than 42%, according to the charity, said that with hindsight, they felt that restraint had sometimes been used “inappropriately”.

Further to these findings, mental health trusts in England could be banned from using face-down restraints.

Let’s discuss…

  • Is physical restraint over-used?
  • Should more restraint training be offered to general nurses?
  • Does training adequately cover de-escalation techniques?
  • Are “face-down restraints” always avoidable?
  • Comments (19)

Readers' comments (19)

  • Anonymous

    As someone specifically qualified as a management of violence training instructor I would just say this. The quality of such training has always been high, even in the days of greater emphases on 1980s type control and restraint type face down restraints trainees were implored by instructors to constantly monitor the subject visually and by communicating with them directly and directing the team accordingly. Unfortnately it seems that the best instructions will be ignored or changed for reasons best explained by psychologists. Thus increasing the frequency of updating must be desirable which must lower the risk of sloppy application. However I have known many properly motivated practitioners who have returned following extended absences of update training who nevertheless continue with excellent technique and attitude.

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  • Anonymous

    The "mouth flappers" from "mind" should volunteer and show us EXACTLY how to manage dangerous an threatening situations !

    It is easy to stand on the sidelines and criticise !

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  • Anonymous

    The people whose opinion should be noted about the effects of physical restraints are the patients. As part of my job I have to attend C+R training and updates on a yearly basis and there is always a service user who gives a speech about the inpact of experiencing this. It was surprising to know that it was not having to be physically restraint that was the problem if done correctly and with empathy. It was when this was done in-correctly, used as punishment, going in flexing your muscles or lack of respect and empathy and most of all not listening or engaging with the person who you are going to restrain.

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  • Anonymous

    Anonymous | 28-Jun-2013 10:22 pm

    excellent comment. how it is carried out is very important. it can be a very unpleasant and frightening experience made worse if it is badly handled but obviously some of the staff may be tense and fearful in case it does not go well for them and threatens their safety. some may have more experience than others and this is where good training and practice is primordial.

    I wonder how much self protection is now taught in nurse training. It seems there is an indication for it on all courses. We did not have it when I was a student as aggression was fairly rare then. The first time I was given a talk on it, but with no practical training, was on an NHS induction course from a police officer whose wife, a nurse, had been seriously assaulted by a patient during the course of her duties.

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  • Anonymous

    I wonder how many mental health staff have been harmed by patients, while undertaking their duties, over the past year?

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  • Anonymous

    Anonymous | 29-Jun-2013 2:23 pm

    why mental health staff? it sounds like discrimination against individuals with mental health issues who are no more harmful than the rest of the population and in fact many are frightened,anxious and withdrawn and have more fear of being harmed themselves. it is only minority who cause deliberate harm to others.

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  • Anonymous

    Where have I generalised about the prevalance of violence amongst the general population of mental health service users? I know the majority of those who experience mental illness do not harm others, so don't assume.
    The research reported is about retraint used by staff in mental health trusts, and I was asking a question about how many mental health staff (the target population in terms of who is most likely to apply physical restraint within mental health trusts) endure assault. A reasonable question in a debate about the use of restraint.

    I experience mental illness myself and have done for the past 20 years and I certainly don't discriminate against others with mental illness. In my experience, restraint is not overused and is applied appropriately by staff who have no more wish to have to use it than those patients who have no wish to endure it.

    Throwing accusations like that, on very little information, perhaps you should check your own attitude.

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  • tinkerbell

    Anonymous | 29-Jun-2013 2:33 pm

    the article is in relation to mental health patients.

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  • Anonymous

    Anonymous | 29-Jun-2013 3:10 pm

    "I wonder how many mental health staff have been harmed by patients, while undertaking their duties, over the past year?"

    suggests they work in mental health units with mental health patients therefore my comment applies.

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  • Anonymous

    Your comment does not apply. How am I being discriminatory against people who experience mental illness because I have asked a question about the assult rates on mental health staff by patients(whatever the setting)?

    As siad, the research is about restraint used against patients in mental health trusts, so why is is discrimination to ask about the assault rates on nurses? **** it infuriates me when people make such assumptions, especially sonce I work with people with mental illness and I have upmost respect and compassion for them - and even after I had to restrain a patient recently who tried to tried to hit me on the head with a heavy blunt object, then followed this up by tring to stab me, I was more soncerned about his welfare than my own.

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