The use of mechanical restraint in mental health: a catalyst for change?

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  The use of mechanical restraint in mental health settings has long been fraught with legal and ethical concerns. Despite prevalent use in other countries, in the UK, devices are rarely used outside of the high secure estate. However, use as a last resort is acknowledged by Mental Health Act legislation and by the Care Quality Commission.
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  As with other containment strategies (such as physical and chemical restraint) there is a paucity of evidence supporting efficacy. Limited guidance exists to support practice, although the British Institute of Learning Disabilities offer excellent guidance.
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  My experience shows that in the right circumstances, mechanical restraint can not only be a viable last resort option with positive outcomes for the patient, but also a self-advocated treatment option in life-threatening circumstances.

The Care Quality Commission recently acknowledged the use of mechanical restraint/s as an intervention for the management of self-harm. I implemented the use of mechanical restraint for a female patient in life-threatening circumstances. This involved an exploration of the defining characteristics as well as the history and ethics of mechanical restraint. Informed consent and examining the legal, ethical and organizational frameworks supporting the use of this intervention in the clinical setting were critical to implementation. Ultimately the outcome not only proved to be life saving, but also a ‘catalyst for change’.