“You are lying down, face on the floor, you can’t hear, you can’t see and it is really, really scary.”
Pamela* experienced restraint a number of times after being admitted to mental health facilities. She described her experiences: “If you resist, sometimes they put pressure specific joints on your body which is just horrific”.
Such experiences of physical restraint are routine in mental health facilities, according to research carried out by Agenda.
We found that one in five women and girls were physically restrained in mental health settings and that the use of face-down restraint continues to be widespread, with women and girls treated this way on thousands of occasions. Girls in particular were more likely to be restrained than boys – with nearly 2,300 incidents of face-down restraint against girls, compared with fewer than 300 against boys.
This is particularly concerning because of the potential it has to re-traumatise the many women and girls who have experienced abuse and violence.
Being physically held down and having your clothes pulled out of place, often in front of others, can be an extremely humiliating, as well as frightening, experience. It is unlikely to improve mental well-being in the short or long-term – and is likely to do the opposite.
But this Friday MPs have the chance to significantly reduce the use of restraint in mental health facilities, and improve the experiences of women like Pamela, and many other vulnerable people admitted into mental health units.
The Mental Health Units (Use of Force) Bill, also known as Seni’s Law, will have its second reading in the House of Commons on Friday 3rd November.
The bill, named after Seni Lewis, who died after 11 police officers restrained him face-down, aims to reduce the use of restraint in mental health units, by significantly improving transparency, accountability, and training for staff carrying out restraint.
The fact that some trusts appear to have almost eliminated physical restraint and to have stopped using face-down restraint altogether shows that change is possible.
If the bill passes, it would mean training for staff on de-escalation techniques, and importantly, on a trauma-informed approach to supporting mental health patients.
Trauma-informed training is essential in improving the experiences of women and girls in particular. Over half of women who have mental health problems have experienced abuse – and the links are particularly pronounced for those with more severe illnesses.
For these women, restraint can bring back painful and frightening memories of previous experiences of abuse, with a risk of re-traumatising them. Restraint is often carried out by male nurses, which can compound the sense of fear and trauma.
Pamela had a history of childhood abuse and she now has flashbacks of her experiences of being restrained. She said: “I think often care plans are not understanding enough if there is a history of abuse and how using prone restraint could affect the person.”
Mental health units are meant to be caring places for women and girls feeling at their most vulnerable, not places where physical force is routine. Restraint should only ever be a last resort.
Recognising women and girls’ specific needs is vital to helping them get better. In particular, women and girls’ histories of trauma need to be taken into account in mental health services, and support given to tackle the underlying issues they face.
If MPs vote in favour of Seni’s Law today, they will have taken a significant first step in ensuring that mental health facilities are the compassionate, therapeutic environments they should be.
*Not her real name