Restrictive practices in Irish mental health centres fall to lowest level on record, new report shows

The combined use of restrictive practices in Irish mental health centres has fallen to its lowest level since national reporting began in 2008, according to a new report published by the Mental Health Commission (MHC).

Entitled The Use of Restrictive Practices in Approved Centres – Activities Report 2024, the report documents the use of seclusion, physical restraint and mechanical restraint across 66 approved inpatient mental health centres nationwide during 2024. This is the MHC’s sixteenth report on the use of seclusion, mechanical means of bodily restraint and physical restraint in approved centres and forms part of its statutory remit to report independently on the quality and safety of mental health services in Ireland.

The report shows that total restrictive practices decreased by 18% in one year, from 3,467 episodes in 2023 to 2,836 episodes in 2024. Over a five-year period, the number of restrictive practice episodes has reduced by almost half, falling by 48.64% from 5,830 in 2020 to 2,836 in 2024.

This represents the lowest annual total since reporting commenced in 2008 .

As part of this ongoing downward trend, the report highlights a sustained reduction in both physical restraint and seclusion, alongside the continued rarity of mechanical restraint. The findings reflect the impact of strengthened oversight, enhanced reporting requirements and the impact of the revised Rules and Codes of Practice introduced by the MHC in January 2023, underpinned by human rights and person-centred care principles. The MHC also acknowledges the ongoing efforts of service providers to adopt a human-rights approach to care and treatment which is resulting in reduction and elimination of restrictive practices. 

The Chief Executive of the Mental Health Commission, John Farrelly, said: “From 2008 to 2018, episodes of physical restraint and the number of residents that were being physically restrained increased year-on-year. It is, therefore, encouraging to note that our work with service providers over the past number of years has continued to result in substantial reductions in restrictive practices, including seclusion. The data for 2024 demonstrates that clinicians and services are increasingly embedding therapeutic, rights-based approaches that prioritise dignity, safety and recovery.”

The Director of Regulation at the Mental Health Commission, Gary Kiernan, said: “The continued decline in restrictive practices signals important and sustained progress in how mental health services are delivered in Ireland. These reductions demonstrate a strong commitment to protecting the human rights of people receiving care and ensuring that coercive interventions are used only as a last resort in strictly controlled circumstances.”

The introduction by the MHC of the revised Rules and Code of Practice on 1 January 2023 was informed by international developments in human rights, advances in trauma-informed and person-centred care, and growing evidence that restrictive practices can cause physical and psychological harm.

“The revised Rules reinforce a rights-based approach to care, requiring approved centres to recognise each person’s inherent dignity and freedom and to ensure that restrictive practices are used only when absolutely necessary, proportionate and for the shortest possible duration,” added Mr Kiernan. “While continued focus is required, the 2024 data provide strong grounds for cautious optimism that restrictive practices will continue to decline.”

The access the full document please follow this link The Use of Restrictive Practices in Approved Centres – Activities Report 2024