Mind is calling on the government and NHS England to put an end to dangerous face down restraint of people with mental health problems in healthcare settings.
Data secured by the charity under the Freedom of Information Act reveals that more than 3,000 patients were restrained in a face down position in 2011-12, despite the increased risk of death from this kind of physical restraint.
There is huge variation in the use of more general restraint and face down restraints across England.
Half of all face down restraint incidents occurred in just two trusts: Northumberland, Tyne and Wear NHS Foundation Trust and Southern Health NHS Foundation Trust.
Yet four others including Hertfordshire Partnership NHS Foundation Trust and West London Mental Health NHS Trust report that they have put an end to using face down restraint altogether.
Paul Farmer, Chief Executive of
Mind, told Central Lobby:
“This issue of restraint has been quite controversial for a while, particularly in the context of incidents outside of mental health care, such as the Winterbourne review and also the Francis report.
“It is really important that there is a focus on people receiving acute and crisis care with dignity and respect.
“The use of restraint is a really important indicator of the way people are being treated.”
There were at least 42,000 recorded incidents of all kinds of physical restraint during the 12 month period, resulting in at least 1,000 injuries to people with mental health problems.
Mind found huge variation between mental health trusts in the use of the physical restraint.
Mr Farmer says physical restraint “can be humiliating, dangerous and in some cases even life-threatening and the huge variation in its use indicates that some trusts are using it too quickly”.
“Face down restraint, when a person is pinned face-down on the floor, is particularly dangerous and has no place in modern healthcare.
“Our research shows that some trusts have a shameful overreliance on physical restraint and use face down physical restraint too readily in their response to managing a crisis situation.”
Mind is calling for national standards on the use of physical restraint and accredited training for frontline healthcare staff.
Its new report on restraint is the latest phase in Mind’s campaign on for better crisis care.
“When changes were made to the NHS by previous governments, a lot of investment was made in community-based mental healthcare such as crisis resolution and early intervention teams,” says Mr Farmer.
“There was investment in very secure mental healthcare facilities, but less policy focus on people who find themselves in need of acute care, people in severe crisis who need care and support, who are too ill to be at home.”
In November 2011 Mind produced its report, Listening to Experience, on the state of mental health crisis care - care for people experiencing a mental health emergency such as a psychotic episode, suicidal feelings or extreme anxiety.
“We spoke to 400 service users, carers and staff, and found that whilst some good care exists, far too many people struggle to access care when they need it and are left feeling isolated, frightened and alone,” says Mr Farmer.
“Inpatient services themselves were failing to treat patients with dignity or respect, and were all too often focused on simply containing people rather than offering therapy.
“The message was that there was good crisis care but it was patchy.
“The experiences people had were that too often they were turned away; there were concerns about levels of safety in wards when you were going in as a voluntary patient.
“We have great examples of things like crisis houses which are not set in hospitals but run in a way to support people in crisis they were scattered rather loosely round the country.”
Last November Mind published data from an FOI request of all mental health trusts.
The data focused on staffing levels and capacity and referral rates, and found huge variations between trusts. It also painted a picture of a service that is overstretched, under-resourced and understaffed, with four in ten trusts failing to meet staffing level benchmarks.
Mr Farmer says while attitudes are changing towards mental health, thanks in part to people such as Stephen Fry being more open about their mental health issues, it remains a ‘Cinderella service”.
“Mental health accounts for 25% of the disease burden in this country but only 12% of the NHS budget,” he says.
“There is very good evince that suggests that 75% of the need is going untreated.
“We need to move towards a significant paradigm shift about how we approach mental health.
“There are some good and encouraging signs but equally as we encourage people to be more open about their mental health, services that are available are not sufficient because they are calculated on a much lower level of assumed need.”