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Figures reveal ‘alarming’ rise in injuries at mental health units

Thousands of patients in NHS mental health units are injured every year when they are restrained by staff, according to new figures which campaigners have branded “horrifying”.

A total of 3,652 patients suffered an injury through being restrained during 2016-17 – the highest number ever – according to data from 48 of England’s 56 mental health trusts. The figures raise serious questions about the effectiveness of the government’s drive to reduce use of techniques which critics say can be traumatic for patients and even endanger their lives.

“Whilst this dramatic increase may be partly explained by improved reporting, the scale of injuries is horrifying. This is also, no doubt, in part due to the stress that many trusts are under, with bed occupancy close to 100% and often relying on agency staff,” said Liberal Democrat MP Norman Lamb. He was the health minister in the coalition government which in 2014 ordered NHS mental health trusts to reduce their use of restraint.

“This amounts to a serious and unacceptable breach of people’s human rights,” he added. “What is most shocking is that some of those against whom restraint is used have suffered abuse in their lives. For them, restraint amounts to an assault, which can be frightening and can completely undermine trust.”

The trusts where the largest number of injuries occurred were Southern Health (534 incidents), Merseycare (493) and South London and the Maudsley (255).

The NHS does not publish annual figures for the number of patients injured due to restraint. But these new statistics are much higher than any previous studies. For example, a survey Lamb undertook last year found that 554 injuries to patients occurred at 22 trusts.

Overall, restraint was used 97,000 times in 2016-17, although some trusts have hugely reduced the number of times they deploy such techniques. Around 2,600 staff were also injured during the use of restraint, with the Greater Manchester trust recording the highest number – 276.

Alison Cobb, a senior policy and campaigns officer at Mind, the mental health charity, said the increase was “alarming”.

“Physical restraint can be humiliating, terrifying and even life-threatening,” she said. “It should only be used as the last resort, when there is no other way of de-escalating a situation where someone may harm themselves or others.”

The Crisis Prevention Institute (CPI), which obtained the figures under Freedom of Information laws, also found that 13% of trusts do not have any restraint policy in place, even though government guidance in 2014 said all providers of mental health care should draw one up.

Martyn Dadds, the CPI’s managing director, said: “Worrying levels of restraint are still taking place, with resulting injuries, despite years of government recommendations designed to reduce these practices. It’s critical that staff are properly trained and that NHS trusts have adequate policies in place to ensure that the most vulnerable members of society, as well as staff, are protected.”

Statutory guidance is needed to improve both standards of training, especially in de-escalation techniques, and the recording of the use of restraint, Dadds added.

The figures come just before Croydon North Labour MP Steve Reed’s mental health units (use of force) bill, which aims to reduce use of restraint, returns to the Commons on Friday. It was inspired by the death of his 23-year-old constituent Olaseni Lewis, who died after being restrained at the Bethlem Royal mental health hospital in Kent in 2010.

Article source: https://www.theguardian.com/society/2018/jun/09/nhs-restraint-techniques-mental-heath-patient-injuries-rise

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