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New restraint guidance for mental health settings

Guidance is based on ‘Seni’s law’, named after a patient who died after being restrained

Guidance is based on ‘Seni’s law’, named after a patient who died after being disproportionately restrained

Mental health settings: Guidance recommends greater training in good restraint methods
Guidance recommends greater training in good restraint methods

New guidance to prevent the use of inappropriate force in mental health settings provides an opportunity to get the culture around using restraint right, a lead nurse has said.

Guidance will ensure trusts and other health bodies are held accountable for the correct use of force

Statutory guidance and regulations published today set out what mental health units must do to comply with the Mental Health Units (Use of Force) Act. The act, known as Seni’s law, was enacted in November 2018, eight years after Olaseni (Seni) Lewis died when he was disproportionately restrained by 11 police officers while he was a voluntary inpatient at Bethlem Royal Hospital in Beckenham, London.

RCN professional lead for learning disabilities Jonathan Beebee said the guidance will ensure trusts and other health bodies are accountable for the correct use of force in their own organisations.

‘Seni’s law looks like a good opportunity to try and get the culture right in mental health units by making trusts and boards more accountable in ensuring there is accurate data on when physical interventions are being used, and making sure that they have got plans in place to minimise the use of restraint,’ he told Nursing Standard.

‘Physical interventions are a part of mental health and learning disability practice that nursing and nursing support workers have to do sometimes to keep people safe, but it’s not something that most nurses are comfortable doing.’

Patients deserve 'compassionate care in an environment that is safe'

Barnet, Enfield and Haringey Mental Health NHS Trust consultant nurse Darren Savarimuthu said that nurses are ‘key players’ in the implementation of this legislation because of how closely they work with patients.

‘It is important that our patients in mental health services receive compassionate care in an environment that is safe, therapeutic and recovery focused,’ he added.

The guidance ensures that under Seni’s law hospitals have to publish data on how and when physical force is used. It also requires mental health staff, including nurses, to be given better training on managing difficult situations.

Seni Lewis's legacy: act outlaws disproportionate use of force

The guidance has been developed through engagement with the mental health sector and a wide range of stakeholders including those with lived experience, the NHS, regulators and Seni’s mother Aji Lewis.

Ms Lewis said she will continue to work with the government and mental health providers to ‘make sure the act is properly implemented and real change is achieved’. ‘This is my son’s legacy, and I hope it will mean that what happened to Seni will not happen to anyone else.’

In 2020-21, some 3,436 people were subject to face-down restraint, according to figures provided by mental health charity Mind.

Mr Lewis was 23 when he died at the psychiatric hospital. In 2017 an inquest jury condemned the actions of police and healthcare staff who watched the restraint of Mr Lewis. The inquest found the force used was excessive and contributed to his death.


Further information

Mental Health Units (Use of Force) Act 2018


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