Service user perspectives on coercion and restraint in mental health

By | 13/08/2017

The article, published in BJPSYCH INTERNATIONAL in August 2017, reports the findings of a survey of service users regarding their experiences of coercion and restraint in the UK and embeds this in the wider international and institutional environment. The article mentions efforts of ENUSP with regard to the UN CRPD: “The European Network for (ex-) Users and Survivors of Psychiatry (ENUSP) has provided a point-by-point explanation of how European human rights legislation is in breach of the CRPD”.

According to the article, in the NSUN study, 94% (n =50) of respondents reported that restraint could have been managed very differently, emphasising that if staff had taken the time to listen and to speak to them addressing fears, frustrations and concerns, the situation could have been avoided. Respondents said that staff needed better training and that service users should be involved in this. The importance of communication is highlighted also in the Promise study (Wilson et al, 2015), where interviewed staff members admit that “if you wish to reduce the number of restraints a high level of communication is needed whatever the issues of a particular patient, whatever their predisposition to violence or hatred of psychiatric staff, or factions within the resident group, or dislikes of a particular patient. In an ideal world there must be more verbal communication …”.

The alarming conclusion of the NSUN study reported in the article is that no differences were found in the experiences of restraint occurring within the past 10 years compared with the past 2 years, which suggests  that the 2 -year UK government programme ‘Positive and Safe’, launched in 2014 with the goal of reducing the need for physical restraint (Department of Health, 2014), has had no impact to date and that a fundamental culture change is needed.

As a side note, the article mentions a horrible case, when a woman eight and a half months pregnant was restrained facedown in July 2016. (Mental Health Today, 2016).