Ban imposed on use of handcuffs and legcuffs on children in mental health services
Mechanical restraints refer to the use of devices or bodily garments which prevent or limit free movement of a person’s body.
The use of mechanical restraints, including hand and leg cuffs, on children has been banned by the Mental Health Commission (MHC).
Its new rules also require all public and private services to publish information about their efforts to reduce and, where possible, eliminate the use of restrictive practices.
MHC’s latest report, which documents the use of such practices in 67 inpatient mental health centres last year, shows there has been a reduction in the use of restraint and seclusion since 2020.
Last year in Ireland, 1,145 people were physically restrained, accounting for 75% of monitored restrictive interventions.
Meanwhile, only the Central Mental Hospital reported the use of mechanical restraint, with handcuffs, last year, with 25 episodes noted — the longest lasting for four hours.
Mechanical restraints refer to the use of devices or bodily garments which prevent or limit free movement of a person’s body, while physical restraint refers to the use of physical force (by one or more persons) for the purpose of preventing the free movement of a person’s body.
A total of 645 people were secluded in 2021, with 14 approved centres recording episodes of seclusion lasting 72 hours or longer.
Seclusion refers to the placing or leaving of a person in any room, at any time, day or night, such that the person is prevented from leaving the room by any means.
The new code of practice will come into effect on January 1, 2023, and includes an outright ban on mechanical restraints on children, including hand and leg cuffs.
“It is clear from the evidence and from the people who took part in our review that restrictive practices are not therapeutic and, indeed, have the potential to cause very serious physical and psychological harm,” said the MHC’s director of regulation Gary Kiernan.
“As well as physical injuries, the use of these interventions may increase the risk of trauma and trigger symptoms associated with previous experiences of trauma.
“Therefore, they must only be used in rare and exceptional circumstances as an emergency measure to keep the person or those around them safe.”
Mr Kiernan added the point of the ban was to “ensure that services intervene with restrictive practices only when absolutely necessary and prioritise positive engagement and empowerment of the person to regain self-control”.
Furthermore, the new requirement for services to publish information about their efforts to reduce such practices “will help to hold organisations and their leaders to account”, he said.
