Policy briefing

Police use of restraint in mental health and learning disability settings

Policy briefing on new guidance on police use of physical restraint in mental health and learning disability settings in England and Wales.
Police_in_hospital_13.jpg

Policy briefing on new guidance on police use of physical restraint in mental health and learning disability settings in England and Wales

Essential facts

In January, new guidance was drawn up for police and healthcare professionals, outlining for the first time how and when police officers should be involved in physically restraining people in healthcare settings in England and Wales.

The memorandum of understanding, aimed at healthcare staff and police officers, clarifies when police should respond to incidents in mental health and learning disability settings, and the extent of their role should they be called to a violent incident.

The 28-page document was produced by the Mental Health and Restraint Expert Reference Group, chaired independently by Lord Carlisle and co-ordinated by the College of

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Policy briefing on new guidance on police use of physical restraint in mental health and learning disability settings in England and Wales


The new guidance clarifies when police should be called to incidents
in mental health settings.   Photo: Apex

Essential facts

In January, new guidance was drawn up for police and healthcare professionals, outlining for the first time how and when police officers should be involved in physically restraining people in healthcare settings in England and Wales.

The memorandum of understanding, aimed at healthcare staff and police officers, clarifies when police should respond to incidents in mental health and learning disability settings, and the extent of their role should they be called to a violent incident.

The 28-page document was produced by the Mental Health and Restraint Expert Reference Group, chaired independently by Lord Carlisle and co-ordinated by the College of Policing. It was developed with the involvement of more than 30 healthcare organisations and people who have experience of being restrained.

The guidance will be integrated into mental health Crisis Care Concordant local action plans in England and Wales.

Overarching ethos

Research by the charity Mind in 2013 highlighted variations in the scale of involvement of the police during the use restraint in England and Wales. Physical restraint has led to injury and even death, and nurses and healthcare professionals are expected to ensure patient safety and minimise unnecessary police involvement in such incidents.

The memorandum of understanding says that each situation should be judged on case-by-case basis. For example, police officers should not be called to incidents relating to purely clinical interventions, such as taking bloods or giving injections, unless exceptional factors apply. These could include where an effort by staff to undertake a restrictive intervention has resulted in injury to staff that compromises their ability to continue safely, or where no other support is available in a timely manner to ensure the safety of all involved.

There are some situations where police attendance would be appropriate, including:

  • Where there is immediate risk to life and limb. For example, the patient is wielding a weapon
  • Where the patient is in possession of an offensive weapon
  • Where there is risk of serious harm to staff
  • Where the patient is causing serious damage to ward property, such as smashing up furniture and continuing to do so
  • Taking a hostage and threatening to harm them.

Mental health staff should involve service users to gain a better understanding of their perspective. Information should be fed back to health commissioners to ensure that services are safe.

Collaborative effort 

Police and healthcare staff should work closely and effectively together by sharing information and communicating clearly to guarantee the safety of patients and staff.

Health staff must alert police officers if there are any concerns about the patient’s welfare during any period of restraint.

The document also highlights the need for senior nurses to share any concerns over police handling of an incident. The document states: ‘Where the senior nurse has concerns about the appropriateness of the police response, they should escalate that to the duty inspector and to their own managers.’

Healthcare staff and police should also be committed to a collaborative effort to review and learn from incidents to prevent violent situations. The document provides guidance on post-incident procedures, with both police and healthcare staff recording details of incidents for joint-review.

Nurses should also consider whether police involvement can be avoided by alerting healthcare managers in advance about patients who may require restrictive interventions, so that enough nursing staff can be made available.

Expert comment

RCN professional Lead for Mental Health Ian Hulatt:

‘This guidance offers clarity for police officers and mental health staff alike, in what are often very challenging circumstances for everyone concerned.

‘It will help ensure the safety and dignity of patients, as well as the medical staff and police officers responsible for providing the care they need.

‘It has been developed with the involvement of more than 30 health and care organisations, including people who have experience of being restrained.’


Find out more

 

RCNi article

 

About the author

 

 

 

Ian Hulatt is RCN professional Lead for Mental Health

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