Face down restraint is still in use in mental health wards in England despite the feeling it should be stopped.
Both the government and the NHS have spoken on this issue. They feel face down restraint should be put to a stop. Its use, which can restrict a patient’s breathing, dropped only slightly over the two years following new guidelines. Some healthcare trainers say face down restraint can be the only appropriate way of keeping staff and patients safe.
In 2013-14, 22.4% of recorded incidents of restraints were face down, falling to 18.5% by 2015-16. The total number of recorded restraints rose by 16.6% from 2013-14 to 2015-16, although NHS managers said better reporting might be part of the reason for the increase. Nonetheless it is still an issue that the government feel should be dealt with.
Norman Lamb is the Liberal Democrat MP for North Norfolk and former Health Minster. He introduced the new guidance in April 2014 and gathered the figures following a Freedom of Information request. Mr Lamb said:
“I find it immensely distressing, to be honest with you, because I know the impact that it has on individuals.
“We have an obligation to those individuals to do better than this.”
Patients who have experienced this kind of restraint have called it humiliating. Some liken it to feeling assaulted and find it incredibly distressing. With one woman (who’s personal details have been kept secret) stating that she could have been spoken to calmly instead.
Professor Tim Kendall is NHS England’s national clinical director for mental health. Regarding face down restraint, he said:
“We are going in the right direction, but there’s a lot of other things that we need to do.
“When you go to an inpatient unit, you are commonly being restricted.
“And that’s bound to produce a reaction in people, and it’s important for all of us to make sure that doesn’t end in restraint.”
He also said trying to stop the practice sent an important signal about “humanising and ethicising and professionalising” mental health services in England. He adds:
“For those trusts not changing things in a positive way, or worse [where] still things are not improving, they really need to take note of this.
“These are real human rights and ethical issues that they should be thinking about.”
What are your thoughts on face down restraint? Do you think it should be stopped or do you think in some situations it is required for safety?