Attending a conference on reducing restrictive practice earlier this week, I found it difficult to hear stories of patient deaths and injuries as a result of restraint.
Having worked as a mental healthcare assistant, I am well aware that restraints do happen. And the fact is that in some cases, they are necessary to protect both staff and patients.
Yet I am also aware of the risks they pose.
I knew that some people have died as a result of restraint, but it wasn’t until I heard first-hand from the mother of a young man who died after being restrained on his stomach for 45 minutes, that it really hit home.
The conference ‘Working together to reduce restrictive practices’, hosted by BILD, Restraint Reduction Network and the Royal College of Psychiatrists, discussed staff and patient safety, new training standards and new legislations known as Seni’s Law.
”Staff are struggling in situations where it’s not always safe for them or their patients”
Professor Tim Kendall, NHS England’s national clinical director for mental health, told the audience: “We have to face the facts… There are some times where people are restrained and die, there are times where staff abuse or mistreat patients, but that is not true for the vast majority of staff. The vast majority of staff actually do a really good job.”
He highlighted that staff are struggling in situations where it’s not always safe for them or their patients. Around the room, many people nodded in agreement.
Acknowledging the issues around restrictive practice, he later stated: “It would be very easy to say we’re going to ban restrictive intervention altogether, but then your staff would all go off sick following all the violence done to them. You have to do this in conjunction, there has to be a stepwise cultural change to keep everybody safe.”
Professor Joy Duxbury, chair of the Restraint Reduction Network and professor of mental health at Manchester Metropolitan University, spoke about the new training standards launched in the House of Lords on Monday.
Created for trainers, the standards are about looking into training, risk, public involvement, engagement with trainers and with a “massive focus” on prevention and de-escalation. There have been cases where trainers have taught professionals to use “almost abusive techniques”; the new standards aim to put a stop to that.
Professor Duxbury acknowledged that this “will weed out some trainers” who may be completely overwhelmed by the standards and what’s required.
The standards document is waiting on a few finishing touches, then it will be interesting to see how it changes staff training and how it will be rolled out across health and social care. Will everyone have to be re-trained in this area? We shall see.
Ms Duxbury then introduced Ajibola Lewis, the mother of Olaseni Lewis, who died in 2010 after being restrained by 11 police officers in Bethlem Royal Hospital, Beckenham.
Ms Lewis discussed Seni’s Law, which was inspired by what happened to her son and passed towards the end of 2018. It means hospitals are now required to publish data on how and when physical force is used, and that any patient deaths in mental health units that result from force by staff will be subject to a review by the secretary of state.
Ms Lewis explained how the journey had been “bittersweet” but knew her son would be smiling.
“We’re just hoping that by passing Seni’s Law, families won’t have to go through what we went through,” she said.
Almost everyone listening had a tear in their eye as she demonstrated with her hands behind her back the agonising position her son was in when he was restrained.
“All professionals need to be aware of the risk of restraint”
She ended by calling on delegates to take “some sort of personal responsibility, to enquire, to read, to find out what is happening to children and adults” in terms of restraint.
She said: “It’s only when things happen to you that you know things are happening in the world. Nobody is immune.”
All professionals need to be aware of the risks of restraint; I will watch with interest how the Restraint Reduction Network’s new standards will affect the sector.