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Open letter: end face-down restraint

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Agenda, end the use of face-down retraints, women and girls, mental health units, open letter, Jeremy HuntResearch shows that in many trusts use of physical restraint is widespread.

The chiefs of eight mental health organisations have sent an open letter to the Health Secretary, Jeremy Hunt, calling for an end to the use of face-down restraint of women and girls after Agenda’s latest research on restraint showed that many women or girls admitted to mental health units find themselves in an environment where physical force has become shockingly routine.

Let’s be clear about this: a woman is held face-down on the floor, unable to move.

Writing in the Guardian recently, Katharine Sacks-Jones, director of Agenda, an alliance of more than 70 organisations, supporting women and girls at risk, said there were nearly 2,300 incidents of face-down restraint against girls, compared with fewer than 300 against boys.

There were also 4,000 incidents of face-down restraint against women, which was more than that of men – despite women being a smaller proportion of patients.

There is not only the issue of the male female ratio, or the physical discomfort, but such ill-handling, often by male nurses, can also bring back memories of abuse and trauma.

The letter, printed in the Guardian, reads:

Dear Jeremy Hunt

New figures released by Agenda, the alliance for women and girls at risk, have highlighted the routine use of physical and face-down restraint against women and girls in mental health settings.

Although government guidance is clear that physical restraint should only be used as a last resort, this research shows that in many trusts it is widespread.

Given that more than half of women who have mental health problems have experienced abuse, restraint not only risks physical harm and can be frightening and humiliating, but being restrained, particularly face-down, can also re-traumatise those with a history of violence and abuse.

Mental health units are meant to be caring, therapeutic environments, for people feeling at their most vulnerable, not places where physical force is routine.

That is why we believe face-down restraint must end and other forms of restraint should only be used as a last resort.

Instead, women and girls’ particular needs and experiences, including their histories of trauma, must be taken into account by mental health services and support given to tackle the underlying issues they face.

It was signed by: Katharine Sacks-Jones, director, Agenda; Paul Farmer, CEO, Mind; Mark Winstanley, chief executive, Rethink Mental Illness; Sarah Hughes, chief executive, Centre for Mental Health; Kathy Roberts, chief executive, Mental Health Providers Forum; Liz Felton, chief executive, Together for Mental Wellbeing; Professor Joy Duxbury, chair, Restraint Reduction Network; and Sarah Brennan, chief executive, YoungMinds.

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