Use of force
'use of force' is a term used to describe types of restrictive practice such as physical restraint, enforced medication and isolation.
Staff will only ever use these restrictive interventions as a last resort and when all other attempts to help have not worked. We recognise that this can be traumatic for all involved and our staff are trained in therapeutic care and de-escalation skills to reduce the need for the use of force.
The Mental Health Units (Use of Force) Act 2018 (also known a Seni’s law) is an act that aims to reduce these interventions and make sure that any use is accurately recorded and monitored.
We will always try to uphold people’s rights to safety and aim to maintain a safe therapeutic environment for all. Sometimes, when somebody is unwell and distressed or agitated, restrictive practice may be needed to keep the person or other people safe.
Do I have a choice?
We encourage all our patients, their families, supporters and advocates to be involved in care planning with staff to help us avoid the use of force. This may involve conversations about what is helpful when someone is becoming distressed and what to do or avoid as far as possible.
Some people might prefer for a certain type of medication or restraint to be used or avoided. This may be recorded in your care planning as a preference, or more formally known as an advanced decision. It may be that in some situations a person’s wishes are overridden to keep themself or others safe.
Patients may be in hospital on a voluntary basis or detained under the Mental Health Act (MHA) which may influence some of the care provided.
In both cases, staff will always explain a person’s rights to them, work collaboratively and only use restrictive interventions as a last resort.
Examples of restrictive interventions
Staff are trained to always use the least restrictive interventions that are a proportionate response to the risk and for no longer than necessary. Staff will always minimise any harm and treat people with respect and dignity.
This training is accredited to meet the Restraint Reduction Network (RRN) Training Standards.
- Standing: Staff members may take hold of a person’s arms and may guide them to another area.
- Seated: Staff members may sit either side of a person in a safe area, and support their arms.
- Beanbag: Staff members may support a person lying on their back, on a beanbag.
- Supine: Staff members may support a person lying on their back on the floor.
- Prone: Staff members may support a person lying on their front on the floor.
- Seclusion: Staff members may guide a person to a designated isolation area, away from others. Staff will remain with the person but will be outside of the room. The person will need to remain in this room until it is safe for them to leave.
- Rapid tranquillisation: Sometimes staff may offer medication to help reduce distress. In cases of extreme distress or agitation and where a person is unable to take medication orally, it may be given as an injection while the person is in restraint.
What happens afterwards?
After any use of force, staff will offer those involved a debrief, this may also include families, carers and advocates. The debrief is a conversation about what has happened and how we can avoid the same situation happening again. Staff will also have their own debrief.
Staff will frequently check physical observations such as blood pressure and pulse. These steps are important because it allows staff the opportunity to check on someone’s physical and mental wellbeing after any use of force.
Concerns about the use of force
If you are concerned about the use of force, we would suggest speaking to staff on the ward.
You may also prefer to speak to an Independent Mental Health Advocate (IMHA) who can also advise you of your rights. Staff can support you to do this.
If you do not feel that your concerns have been fully addressed you may wish to consider making a complaint, you can do this in the following ways.
PALS freephone 0800 587 4997
Complaints Team 01202 277024/277025
Aged 18+: SWAN Independent Mental Health Advocacy (IMHA): 03333 447928 Get somebody to speak for you so you can get support - Dorset Council
From birth to 18 ‘National Youth Advocacy Service (NYAS): 08088 081001 Independent advocacy - Dorset Council
4-6 Nuffield Road
Poole BH17 0RB