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Mental Health Commission to ban mechanical restraints on children in inpatient centres

The practice involves handcuffs, or devices and garments that stop a person moving.

Image: Shutterstock/sdecoret

THE USE OF devices or bodily garments for preventing a person’s movements will no longer be permitted to be used on children following a review of Ireland’s mental health centres by the Mental Health Commission (MHC).

The practice, known as mechanical restraint and often involving handcuffs, will be banned from 1 January 2023.

The new rules are the result of a review that began 18 months ago and will also halve how long an adult inpatient can be locked in their room, or ‘secluded’, from eight hours to four hours.

The director of regulation for the MHC, Gary Kiernan, stated:

“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.

“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.

“The published evidence shows that children and young people 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 provisions to protect children, including a complete ban on mechanical means of bodily restraint for children.”

The MHC also released a report into the use of seclusion and restraints into 67 inpatient mental health centres in Ireland in 2021.

It found that 645 people were secluded last year, with 6% of them being prevented from leaving their rooms for more than 72 hours.

The duration for a single episode of seclusion ranged from 3 minutes to 8,759 hours (1 year).

This method was used in 25% of instances where a centre would restrict a person’s movement due to a belief they were a risk to themselves or others.

Far more common was physical restraint, where staff members would stop a patient from moving freely, which was used the other 75% of the time.

The MHC has also reduced the permitted maximum duration of this from 30 minutes to 10 minutes.

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