Reducing restrictive interventionsBack to Nursing Essentials Crib Cards
Everyone’s human rights must be respected and protected. This includes ensuring that any restriction of a person’s freedom or liberty is undertaken with great caution. The effects of being restrained, doing restraint and those witnessing such actions can be very distressing. Restrictive interventions may perpetuate trauma, can be hazardous and have the potential to cause serious harm to people’s physical, emotional and psychological wellbeing.
At times, a person may become highly confused, anxious or disorientated which can lead to behaviours that put them or others into dangerous situations. In such circumstances, there is a very real possibility of harm to the person or others, if no action is taken. Practitioners must identify, offer and work with the least restriction option to maintain the person’s safety and care.
- The nature of techniques used to restrict or restrain a person must be proportionate to the likelihood and seriousness harm.
- Any restriction of a person’s freedom of movement must be the least restrictive option that will meet the need.
- Any restriction should be imposed for no longer than absolutely necessary.
- Under what circumstances, what is done, why and with what consequences must be subject to audit and monitoring, and must always be recorded fully, in an open and transparent manner.
Restrictive interventions are more diverse than just physical restraint; they can include restricting visits, property (mobile phones, computers), withholding information and contact with family members as well as forms of mechanical and chemical restraint. They can include environmental restrictions, such as locked doors, positioning furniture to restrict movement, and use of seclusion or segregation.
Restrictive interventions or practices should only be used as a last resort and there must be a demonstrable necessity to act. They should never be used to punish or for the sole intention of inflicting pain, suffering or humiliation.
All organisations have a role to play in implementing trauma-informed care. Services should have local policies, based on national guidance, for the safe and lawful use of restrictive interventions. These should include provision for proactive approaches to avoid situations where people’s behaviour escalates to the point where restraint may be required.
- Mental Capacity Act 2005
- Mental Health (Care and Treatment) (Scotland) Act 2003
- Adults with Incapacity (Scotland) Act 2000
- The Mental Health (Northern Ireland) Order 1986
- Mental Health Act 1983