New guidelines drawn up on use of restraint in mental health settings focus on care rather than control
People restrained in mental health settings will get the care they need ‘rather than control’ under new guidelines drawn up for police and healthcare professionals.
The Memorandum of Understanding (MoU) draws up a national position about when the police can be asked to attend mental health and learning disability settings and for what reasons – something that wasn’t in place before.
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. But research by mental health charity Mind in 2013 revealed significant variance in the extent to which healthcare providers call the police for support around restraint and restrictive practices.
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.
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.”
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 30 health and care organisations including people who have experience of being restrained.
Paul Farmer, CEO of Mind, welcomed the guidance. “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.”
Dr Adrian James, registrar of the Royal College of Psychiatrists, also welcomed the new guidelines. “Their 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,” he said. “We very much value working together with our police colleagues and welcome the focus that the College of Policing has given to this area.
“The guidelines were created in collaboration with service users, carers, health professionals and the police to develop positive policy and we look forward to their implementation.”
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