NHS senior managers and staff are greatly concerned of the increased risk to staff and patients without the presence of Police Officers during restraint incidents.
Why? Yes, that’s correct; I’d like to know why? Well, in order to justify the question, let me ask a couple of my own…
How quickly do the Police respond to an incident of restraint in a psychiatric unit?
Having been involved in more incidents of restraint than I can remember, I can quite comfortably state that in a spontaneous instance of restraint anything over 30- 45 seconds is usually too late. Either the person being restrained is under control, or worse the restraining staff have been overpowered. Police response time would only be of little concern if the patient is contained and needs to be relocated safely.
The other concern when considering Police response times is the position of the patient while staff wait for Officers to arrive. If staff have pinned a patient face down in the prone position and have no way of transferring the patient to a seated or standing position, there is a very real risk to the patient’s life by way of positional asphyxia.
Do Police Officers receive the same level of training as Psychiatric Care Staff with regard to the needs of mental health patients?
Well, to be quite frank, no they don’t. If a Police Officer is called to restrain a mental health patient they will treat the individual the same as any other member of the public they encounter in the street. The Officers are then accused of not being ‘sensitive’ enough and treating the patient ‘like a criminal’. The problem arises when the patient, who may not understand what is happening, reacts defensively toward a Police Officer. The Officer is aware of the increased level of resistance and violence, and increases the level of force used to restrain the patient. The Officer is not at fault in this instance. After all, they have been called to restrain this violent individual and as such the safety of the Officer is at risk. They are, quite rightly, going to employ the techniques they are taught to ensure their own safety and that of everyone concerned.
This scenario could have lasting emotional and psychiatric consequences for the patient, and indeed the staff involved.
If Police Officers will no longer attend incidents of restraint, who will restrain patients instead?
In short, the care staff will. A suitable and sufficient risk assessment will already have been carried out, and it is the duty of senior managers to review the risk assessment in order to protect the health and safety of staff and patients as the level of risk has increased. The obvious reaction to this review will be fit for purpose training in restraint for all staff directly involved with patients.
This should include instruction in breakaway techniques in addition to low and high level restraint training. Included in this training would be a wide variety of controlling techniques as well as medical considerations to be vigilant about, including positional asphyxia.
Shouldn’t the care staff already be trained in the use of restraint?
If it has been recognised that Police intervention is required to restrain certain patients with enough frequency for it to be of concern to Met Police, then in accordance with The Management of Health and Safety Regulations 1999 the risk assessments should be reviewed and any current control measures that aren’t working need to be addressed in to reduce or even eliminate the risks.
It could be argued that the staff in psychiatric units should already be trained to a high enough level to not need Police intervention.
When I’ve spoken to care homes and psychiatric units in the past and raised the subject of high level restraint techniques and the use mechanical restraints (handcuffs), the managers have responded with wide eyes and instant refusal to discuss the employment of such techniques, due to the use of handcuffs and restrictive techniques potentially damaging the ‘caring establishment’ image. However, the same managers are quite content to call for Police Officers to arrive at the ‘caring establishment’ with their body armour, handcuffs and even Tasers to regain control and subdue the patient. Once the situation is resolved those same managers often criticise the Police Officers for being too ‘over the top’ and not being ‘sensitive’ enough.
Article from PoliceOracle.com
“Mental Health: ‘Officers should not restrain patients'”
Date – 27th June 2013
By – Jack Sommers – Police Oracle
Healthcare professionals should use their training on the control of mentally ill patients to restrain them rather than relying on police officers, Federation officials have said.
Kevin Huish, the Fed’s lead on mental health issues, said that mental health professionals receive specialist training in the control and restraint of mentally ill patients and have powers to sedate them. Officers are only trained to subdue, restrain and arrest violent people, he added.
In a submission to the Home Office he said that police officers should not be called to mental health premises to assist in the restraint of aggressive or violent patients.
He told PoliceOracle.com: “People in mental healthcare settings are ill and are not always in control of their actions but all should still be treated with dignity and respect by all professionals who come into contact with them.
“It is not always easy and frequently very difficult but that is why mentally ill people have been sectioned in the first instance and those caring for them are fully aware of this.”
Mr Huish was speaking after mental health charity Mind noted sharp differences between how often different mental health trusts called officers to restrain patients when their staff could not cope with them.
The charity asked 55 mental health trusts how often they called police to restrain patients. Those that responded noted 361 incidents among 27 trusts in 2011/12 – one trust recorded doing this 100 times while three said they had never called officers out in the same period.
“Given this variation in the need to call the police, it raises the question of how necessary or appropriate it is to call law enforcement into health settings,” the charity’s report said.
“One person responding to our inquiry, who witnessed physical restraint on a ward, described what happened when staff were unable to de-escalate a situation and police were called in, ‘storming the car-park, alarming visitors and patients’. They heard staff making accusations to someone, which did nothing to defuse things, and police mocking the situation.”
Mr Huish explained that his submission to the Home Office was in response to its review surrounding aspects of mental health legislation. Home Secretary Theresa May discussed this at the Police Federation conference last month.
At the event, Mrs May said police officers were spending too much time trying to ensure the safety of those with mental health issues.
She added: “I want to work with the Federation to get things like mental health right, not just for the patients we’re talking about but for the NHS and the police too. I believe things are better, indeed the outcomes are better for both the police and the public, when we work together.”