Use of physical restraint on mental health patients at ‘disturbing levels’ society the guardian brain anoxia

Physical restraint can be humiliating, dangerous and even life-threatening, says paul farmer, chief executive of mind. Photograph: graham turner for the guardian

Nearly 40,000 incidents of physical restraint on mental health patients in england were recorded in one year, with more than 3,000 in the dangerous face-down position, according to figures released by a charity.

Mind said data obtained under the freedom of information act showed 39,883 recorded incidents of physical restraint in mental health trusts during 2011-12, resulting in at least 949 injuries to people with mental health problems.

The charity said there was huge variation between trusts in the use of physical restraint.

Surrey and borders NHS foundation trust reported 38 incidents over the year; tees, esk and wear valleys NHS foundation trust reported 3,346.Brain anoxia the charity said the figures for overall physical restraint incidents, including face-down, were compiled from answers provided by 51 mental trusts.

More than half of the responding trusts (27) said 3,439 of the incidents were of face-down restraint, a potentially life-threatening method, according to mind. Northumberland, tyne and wear NHS foundation trust recorded 923 incidents of face-down restraint and southern health NHS foundation trust 810.

A separate survey by mind of 375 frontline healthcare staff involved in physically restraining people with mental health problems showed almost a quarter (22%) had not had face-to-face training on physical restraint techniques in the past 12 months.

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More than four in 10 (42%), according to the charity, said, with hindsight, they felt restraint had sometimes been used inappropriately.

Paul farmer, mind’s chief executive, said: physical restraint can be humiliating, dangerous and 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, as well as extremely frightening to the person being restrained. It has no place in modern healthcare and its use must be ended.

Deborah coles, co-director of the campaigning group inquest, said: despite the plethora of restraint-related recommendations from inquests and inquiries into deaths, it is shocking that restraint is still relied upon at such disturbing levels.Brain anoxia

A statement from northumberland, tyne and wear NHS trust said: reasons for restraint can include a patient being violent or aggressive to either themselves or others, with a small percentage of patients requiring high levels of restraint due to the complex nature of their illness. Analysis of our figures has shown that a small group of less than 50 patients, who demonstrate very complex and high-risk behaviours, account for over two-thirds of the recorded incidents of restraint.

Our staff are given extensive training in recognition, prevention and de-escalation skills, as well as methods of physical restraint and the risks associated with the use of physical restraint to ensure that they can manage episodes of violence and aggression in a safe, supportive, dignified and professional manner in line with national guidance and the best available evidence.Brain anoxia

Inquest co-director deborah coles says it is shocking that physical restraint is still relied upon at such disturbing levels. Photograph: graham turner for the guardian

Due to the specialist nature of a number of our services such as our forensic services, the trust cares for some of the most complex and challenging patients from all over the country, which means that the figures may be higher when comparing to areas without such specialist services.

Lesley stevens, clinical director of mental health services at southern health NHS foundation trust, said: southern health is one of the largest providers of mental health and learning disability services in england. We also support people who have been involved in the criminal justice system and other highly complex and challenging people who require very intensive care.Brain anoxia our figures for restraint are comparable with other trusts which provide similar regional and national services. Our staff are trained to understand the triggers which can lead to aggression so they can act early to avoid the need for physical restraint.

Jo young, of surrey and borders partnership NHS foundation trust, said: we welcome this report from mind and their call for national standards to reduce the instances of physical restraint on mental health wards. Ensuring people who use our services are treated with dignity and our culture of mutual respect on our wards are both core to our service delivery.

A spokeswoman for tees, esk and wear valleys NHS foundation trust said: the number of incidents may seem high.Brain anoxia however, we are one of the largest mental health and learning disability trusts in the country, with over 1,000 beds and a high proportion of specialist units caring for people with extremely challenging behaviour.

Physical restraint, using nationally accredited techniques, is only used as a last resort. Many of the incidents reported involved only minimal restraint but it is our policy to record all incidents, regardless of level of restraint, so that we can monitor, review and learn from them.