Report reveals worrying trends in seclusion and restraint
A new report by the Mental Health Commission has revealed a 57% increase in episodes of restrictive practices on patients, in Ireland’s in-patient mental health facilities over the past 10 years.
The report documents the use of seclusion, mechanical restraint and physical restraint in all approved centres for the care and treatment of those suffering from mental illness during the years 2017 and 2018. However, it also draws comparisons with figures reported by the Commission in 2008 - the year the mental health regulator first commenced reporting on restrictive practices across approved units.
We reported 4,765 combined episodes of physical restraint and seclusion in 2008. In contrast, it is reported that there were 7,420 episodes of restrictive practices reported to the Commission in 2017, and 7,464 in 2018. The 2018 figure equates to a 57% increase in the total reported for 2008.
“This report provides information on the use of restrictive practices, the services using them, the people affected, and the quality and safety of the interventions,” said Director of Standards and Quality Assurance at the Mental Health Commission, Rosemary Smyth.
The Chief Executive of the Mental Health Commission, John Farrelly, said that while the report clearly demonstrated an open culture of reporting, it also evidenced a lack of oversight and governance in the use of restrictive practices by the Health Service Executive (HSE) over a 10-year period. “It’s very heartening that the people working in our mental health services are both forthcoming and honest when it comes to reporting instances of restrictive practices. We want that to continue, and services and their staff should be complemented for their courage and candour in this respect.
We continue to strongly advocate for the use of de-escalation measures over restrictive practices. For these measures to be successful, it is essential that staff are appropriately trained in de-escalation and in clinical risk management. In 2017, we set mandatory training for all healthcare professionals in approved centres in the prevention, de-escalation and management of violence and aggression.
The Mental Health Commission has written to the HSE seeking a clear strategy and implementation plan that will contribute towards a significant reduction in episodes of restrictive practices across the country’s mental health services. This plan should also set out how the HSE plans to increase compliance with the regulation on de-escalation training.
To read the full report please click here.
