Over 3,000 episodes of physical restraint in mental health centres in 2011

A NEW REPORT on mental health centres in Ireland has revealed that a total of 3,056 episodes of physical restraint were reported in 2011. The report by the Mental Health Commission said this figure represents an increase of 71 compared to the number recorded in 2010,

Overall use of restrictive practices in 2011 were down by almost 12 per cent on the previous year and the the use of seclusion and mechanical means of bodily restraint has also steadily declined since 2008.

However the report said there has been a year-on-year increase in the use of physical restraint.

Seclusion accounted for 35.5 per cent of all restrictive interventions reported to the Commission in 2011 with 1,683 episodes reported. Less than half, 47.1 per cent, of approved centres (32/68) indicated that they used seclusion in 2011 and the remainder (36) reported that they did not use seclusion at all.

Dublin North Central and Dublin North West had the highest rate of seclusion followed closely by Waterford/Wexford.

For the fourth year, St Joseph’s Intellectual Disability Services at St Ita’s Hospital in North Dublin recorded the highest number of episodes of seclusion. They reported 369 episodes of seclusion in 2011, a notable decrease on use reported in 2010 when there were 711 episodes of seclusion in this approved centre.

Two dedicated child and adolescent approved centres, the Adolescent In-patient Unit, St Vincent’s Hospital and the Child & Adolescent Mental Health In-patient Unit, Merlin Park University Hospital, reported that they used seclusion in 2011.

As in previous years, the percentage of males secluded were greater than that of females at over 60 per cent.

The majority 51.6 per cent of seclusion episodes lasted for four hours or less and three-quarters (75.2 per cent) lasted for eight hours or less. In 16 per cent of episodes, seclusion lasted between eight and 24 hours and in a further 6.9 per cent of episodes it lasted between 24 and 72 hours.

Only three approved centres reported using mechanical restraint while over three quarters recorded episodes of physical restraint.

St Joseph’s Intellectual Disability Services in St Ita’s Hospital recorded the highest number of physical restraint episodes of all approved centres in 2011. This intervention was used 366 times in 2011, which was considerably less than their use of physical restraint in 2010 when they reported 616 episodes.

All dedicated child and adolescent approved centres (5) reported using physical restraint, usage was up from 100 episodes in 2010 to 214 episodes in 2011.

In 2011, 90.5 per cent of physical restraint episodes lasted for 15 minutes or less and 7.9 per cent of episodes lasted for between 16 and 30 minutes. Fifty one episodes (1.7 per cent) lasted for more than 30 minutes, of which ten (0.3 per cent) lasted for more than one hour. In 2010, four episodes lasted for longer than one hour.

Commenting on the publication of the report today, John Saunders, Chairman of the Mental Health Commission said it is the watchdog’s view that “the use of seclusion and restraint are not standard interventions but emergency measures which should be used in rare and exceptional circumstances and only in the best interests of the patient when the patient poses an immediate threat of serious harm to self or others”.

“Our aim is to encourage approved centres to focus on preventative measures that eliminate or minimise the use of restrictive interventions,” he said. “To that end the Commission has during 2012 completed a consultation exercise on a seclusion and physical restraint reduction strategy,” he added.

The strategy is expected to be published during 2013 and it will be implemented nationwide.

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