The troubling secrets of England’s mental hospitals

 

Sheffield Mental Health Trust's Tim Kendall stopped the use of face-down restraint after experiencing it himself

Perhaps even more disturbing than what we now know about the "excessive" use of face-down restraint inside some English mental hospitals is what we don't know.

Six of the 54 mental health trusts replied to a Freedom of Information request saying they could not say how often any form of restraint was used. Half of them could not provide details of how often their staff had used the controversial and dangerous face-down technique.

Under the Mental Health Act 1983, institutions are statutorily obliged to "document and review every episode of physical restraint which should include a detailed account of the restraint".

The Health Minister Norman Lamb is concerned that such partial records of these traumatic and potentially lethal procedures are available. "We just don't know enough about what goes on in mental health, how resources are used, what the practices are and that needs to change," he told me.

I understand he has asked officials to look at demanding all trusts openly publish the details of all restraint and seclusion they use. The secrecy that surrounds mental health remains deeply troubling.

David "Rocky" Bennett David Bennett died in 1998 after being restrained at a Norwich clinic

However, ministers and NHS England have questions to answer:

  • Why did it take an independent charity, Mind, to reveal the variation in the use of restraint and the yawning gaps in the available data?
  • Who is policing the law in this area?
  • What happens to all the "reviews" and documentation that supposedly follow each of the tens of thousands of restraint incidents conducted each year?

A spokesperson for NHS England tells me that the issue of restraint is "a priority" and work is underway to identify the best policies and practices to minimise its use.

But it is almost 15 years since a government-commissioned independent inquiry into the death of David "Rocky" Bennett demanded almost exactly that.

"This is another example of the lack of parity of esteem between mental health and physical health," Mr Lamb says.

It is hard not to agree.

 
Mark Easton Article written by Mark Easton Mark Easton Home editor

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  • rate this
    +1

    Comment number 37.

    @35 and 36
    Violence towards yourself is still violence, for God’s sake! (And would still need to be stopped by staff! ) And if you actually read what I said, you will see that I stated “they are sectioned primarily for the safety of others AND THEMSELVES”.
    But hey, don’t let the facts stop you from feeling superior and correcting someone!

  • rate this
    0

    Comment number 36.

    #34 - I'm afraid I disagree with your assertion "A high proportion inside mental hospitals are violent".The majority of mental health inpatients are there to ensure their own safety.Frequently the issue is one of feeling overwhelmed and/or unable to cope, coupled with a serious risk to personal safety.Problems like depression, anorexia, mania et al are not characterised by violence to others.

  • rate this
    -1

    Comment number 35.

    Tanglefoot is talking nonsense, the vast majority of patients are voluntary. http://www.mind.org.uk/mental_health_a-z/8052_mental_health_act
    And the majority of those Sectioned under the Mental Health Act are there because they are a danger to themselves, not others.

  • rate this
    +1

    Comment number 34.

    OF COURSE not all people who are mentally ill are violent. But the vast majority of people who are mentally ill are not inside mental hospitals, they remain in the community. A high proportion inside mental hospitals are violent, that is often why they are there, they are "sectioned" primarily for the safety of others and themselves, rather than for their own treatment. That is the sad reality..

  • rate this
    +2

    Comment number 33.

    @6 - Tanglefoot
    I agree that quality of staff is variable, but then, so is the nature of psychiatric theory in general. In terms of remuneration, I certainly don't do it for the money - mental health nursing is not a cash cow. Problems have arisen when people, who do not and have not worked on the 'shop floor', make decisions to cut and trim services. Francis report, anyone?

 

Comments 5 of 37

 

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