Working for the NHS in a mental health setting should be a therapeutic environment, however recent news has shown that this is not always the case. If a patient becomes out of control and physical intervention is required, it should only be carried out as an absolute last resort and in a safe way to both parties.
IKON believe that a Physical Intervention technique shouldn’t result in the patient finding themselves face-down. Despite the Government and the NHS saying that face-down physical restraint needs to stop, it is still being used in mental health wards across England. In 2013-14, 22.4% of recorded incidents of restraints were face-down and it fell by only 3.9% in 2015-16. It took Norman Lamb, the Liberal Democrat MP for North Norfolk and former Health Minister, to initiate a Freedom of Information request for the figures to be released.
With some healthcare trainers saying that face-down restraint is the only appropriate way of keeping employees and patients safe, it’s no wonder that face-down restraint figures aren’t decreasing any time soon. This evidence proves that more needs to be done to educate the healthcare employees that work with mental health patients. It can only make us wonder, do these trainers consider the fact that they might be injuring or mentally affecting their patient even more than they already are currently? Restraining in this way can cause positional asphyxia, an issue that can occur when the chest is pressed against the floor.
Professor Tim Kendall, NHS England’s national clinical director for mental health, said: “We are going in the right direction, but there’s a lot of other things that we need to do. When you go to an inpatient unit, you are commonly being restricted and that’s bound to produce a reaction in people, and it’s important for all of us to make sure that doesn’t end in restraint.” He also said that trying to stop the practice sent an important signal about “humanising, ethicising and professionalising” mental health services in England.
As part of our Physical Intervention Training course, IKON reinforces the fact that we follow government initiatives by not promoting face-down restraint techniques. Our Training teaches that patients can be restrained without the need to put them face-down – using a supine (face-up) rather than prone restraint. We believe restraining should be done in a safe, effective way which causes no physical harm to the patient but gives the members of staff enough time to ensure the patient becomes calm.
We strongly believe that communication is always the first step in the process of controlling and defusing challenging behaviour but at the same time recognise there is sometimes a need to intervene in a physical manner as a last resort.
We have a professional duty to train healthcare employees in sound and effective communication skills for challenging behaviour.
IKON Training would like to play as big a part as possible in helping to reduce the number of face-down restraint incidents. We want to spend the time helping Trusts and Mental Health Organisations to effectively control challenging behaviour. We do recognise that it’s not always possible to stay away from Physical Intervention restraints but want to emphasise the fact that no matter how difficult it gets, face-down restraint shouldn’t be a solution to the problem.
IKON recommends that a minimum of 1 other person is present to try and communicate with the patient whilst they are being restrained. Even if a patient is being un-cooperative or being physically abusive, healthcare professionals must ensure that they still consider the person’s rights and the fact that they are a patient – with medical reasons for their challenging behaviour. Ethical issues must also be taken into consideration; would they like a member of their family to be restrained in that way?
Not only can face-down restraint cause physical harm to the patient, but it can also result in further additional and lasting mental health issues. Will it unnecessarily prolong or add to the difficulties they then must live with?
If you’d like to talk through your Healthcare Organisation’s options to tackle face-down restraint, please contact one of our team on 01473 722924. We’ll ask you a few questions to ascertain the best training we can provide.