Proposed changes to reporting on restraint in mental health units

Our consultation response was co-written with Lived Experience Experts (LEEs) who contributed their direct experiences of either working in mental health trusts or as inpatients or family members of those accessing mental health services. BIHR also drew on our experience of running human rights programmes with mental health trusts from across the UK and of working with individuals and community groups to support them to understand their rights. 

We said that while we agree with the principle of introducing a measure to report all forms of restraint within 72 hours and the aim of increasing accountability, a reporting duty alone is not enough to effectively decrease the use of restraint. We believe the proposals must sit alongside a mandatory requirement for staff to be trained in human rights and supported to use a framework to make individualised and proportionate decisions. We raised several concerns, including:

Staff must be supported to use human rights frameworks to make rights-respecting decisions that are less likely to lead to restraint in the first place.   

Without information about, for example, whether there was a debrief or changes made to care planning with the involvement of the individual, the CQC cannot fully assess if a mental unit has culture in which practitioners are supported to review, reflect and learn from approaches to restraint. 

We know that restraint often has a serious and long-term impact on a person. Without the perspective of the person and data which understands the impact on them, potential breaches of a person’s human rights may be missed.  

Additional bureaucracy within the context of understaffed and over stretched units will exacerbate existing issues and may have unintended consequences for people’s human rights