25 January 2017

Use of restraint in mental health settings

People restrained in mental health settings will get the care they need ‘rather than control’ under new Memorandum of Understanding (MoU) drawn up for police and healthcare professionals.   

​Until now there was no clear national position about when the police can be asked to attend mental health and learning disability settings and for what reasons.

Police officers do not have specific powers to restrain a patient for the purposes of medical treatment regardless of whether the treatment is in the patient's best interests however, research by Mind in 2013 revealed there is significant variance in the extent to which healthcare providers call the police for support around restraint and restrictive practices.

Commander Christine Jones, National Police Chiefs' Council lead for mental health, said: "We know physical restraint can be humiliating, terrifying, dangerous and even life-threatening.

"Today, for the first time, a Memorandum of Understanding has been agreed that sets a clear national position about when the police can be asked to attend mental health settings, for what reasons and what can be expected of them when they do attend."

The MoU outlines police powers, the law, what healthcare professionals are committed to doing, how to manage uncertainties, restraint and restrictive practices and practical case studies showing good practice.  It also encourages police and healthcare professionals to continue reviewing and learning from incidents.

It represents two years of work by a group independently chaired by Lord Carlile of Berriew CBE QC and applies to all patients regardless of whether they are detained under the Mental Health Act 1983.

Lord Carlile, Chair of the Mental Health and Restraint Expert Reference Group, said: "Being restrained by police in these settings can trigger psychological trauma, especially for people with previous experience of physical or sexual abuse.

"The work we have done means every mental health provider in England and Wales now has a single document which clearly outlines their role and the role of others.

"This means the public will get the care they need, rather than control, and at the right time."

It is supported by the Royal College of Psychiatrists, Royal College of Nursing, Mind, The Faculty of Forensic and Legal Medicine and the National Police Chiefs' Council.

As the professional body for the police, the College of Policing was responsible for coordinating the MoU.

Ian Hulatt, Professional Lead for Mental Health at the Royal College of Nursing, said: "This guidance offers clarity for police officers and mental health staff alike, in what are often very challenging circumstances for everyone concerned.

"It will help ensure the safety and dignity of patients, as well as the medical staff and police officers responsible for providing the care they need."

It has been developed with the involvement of more than thirty health and care organisations including people who have experience of being restrained.

Dr Adrian James, Registrar of the Royal College of Psychiatrists said: "The new guidelines were created in collaboration with service users, carers, health professionals and the police to develop positive policy.

"The aim is to make it safer and more dignified for service users, and for the police to engage more effectively in relation to their contact with people who have mental health problems. We very much value working together with our police colleagues and welcome the focus that the College of Policing has given to this area. 
"We look forward to the implementation of the new guidelines."

Paul Farmer, CEO of Mind, said: "We welcome this guidance, which clearly outlines how and when police should be involved in physical restraint in a healthcare setting.

"When someone is having a mental health crisis, they become frustrated, frightened and extremely distressed and when someone is at their lowest point, they need help, not harm.

"Physical restraint should only be used as the last resort so it is vital there is clarity across all organisations about how to manage difficult situations appropriately.

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