Ban on the mechanical restraints of children in inpatient psychiatric institutions

The use of mechanical restraints on children has been banned following an extensive review and consultation process by the Inspectorate on the rules and codes of practice governing the use of restrictive practices in mental health inpatient settings in Ireland.

The Mental Health Commission said the outcome of the review, which began more than 18 months ago, will include new rules on seclusion and mechanical restraints, as well as a new code of practice on physical restraints, all of which will come into effect from January.

“The new rules include an absolute ban on the use of mechanical means of physical restraint on children, including the use of handcuffs and leg irons.

They will also require all public and private services to release information about their efforts to reduce and, where possible, eliminate the use of restrictive practices.”

Gary Kiernan, Director of Regulations for the Mental Health Commission, said: “It is clear from the evidence and the people who participated in our review that restrictive practices are not therapeutic and do in fact have the potential to cause very serious physical and mental health problems cause damage.

“Besides physical injury, the use of these interventions can increase the risk of trauma and trigger symptoms associated with previous trauma experiences.

“Therefore, they may only be used in rare and exceptional circumstances as an emergency measure to protect the person or their surroundings.

“The published evidence shows that children and adolescents are particularly vulnerable to trauma and injury as a result of these practices.

“We have paid particular attention to this area and introduced a number of new child protection regulations, including a total ban on the use of mechanical restraints on children.”
He said the point of the revised rules is to ensure services only intervene with restrictive practices when absolutely necessary and to prioritize positive engagement and empowering the individual to regain self-control.

“We believe that our requirement for the services to publicly disclose information about their efforts to reduce and eliminate these practices will help hold organizations and their leaders accountable.
“Many Irish mental health services have already successfully adopted this approach.

“They have shown – particularly in recent years – that they are actively working to dismantle restrictive practices.

“The MHC’s 2021 Activity Report, which we are also releasing today, shows a further significant decrease in episodes of seclusion and physical restraint. However, we need to see further reductions and a continuation of this downtrend in line with contemporary and international best practices. ”
Chief Executive John Farrelly said that while restrictive practices may occasionally be necessary to ensure safety in the day-to-day environment of an acute mental health service, the MHC nonetheless expects the use of these practices to be reduced from 2023 onwards.
“For this to happen, services need to own these rules and clearly demonstrate their commitment to their implementation.

“As a regulator, we believe the publication of these Rules and Codes represents an important milestone in further reducing and, where possible, eliminating restrictive practices in our inpatient mental health services.”
Like the current Rules and Code of Conduct, which came into effect on January 1, 2010, the revised Rules and Code of Conduct will apply to all inpatient mental health services in the public, voluntary and independent sectors from January 1, 2023.

The MHC will provide training and resources for services in the coming weeks and months leading up to this date.

A report on restrictive practices at 67 residential mental health centers in Ireland in 2021 showed that a total of 4,636 episodes of seclusion and physical restraint were recorded across the country last year, involving 1,790 residents of licensed centres.

This represented a decrease from 2020 when there were a total of 5,830 seclusion and physical restraint episodes involving 1,880 residents.

In 2019, there were a total of 6,747 combined episodes of isolation and physical restraint involving 1,803 residents.

In 2021, there were 3,460 episodes of physical restraint. This represents a decrease from 3,990 episodes in 2020 and a significant decrease from 5,029 episodes in 2019.

A total of 1,145 people were physically restrained in 2021, compared to 1,211 residents in 2020. A total of 287 hours and 16 minutes of physical restraint was reported nationwide in 2021, significantly less than 2020 (402 hours 20 minutes) and 2019 -632 hours 53 minutes.

https://www.independent.ie/irish-news/ban-issued-on-mechanical-restraint-of-children-in-inpatient-mental-health-settings-42024008.html Ban on the mechanical restraints of children in inpatient psychiatric institutions

Fry Electronics Team

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