New Research Highlights the Harm of Restrictive Practices in Mental Health Care and the Promise of Compassionate Approaches

Restrictive practices such as physical restraint and seclusion have been traditionally used in mental health settings as a last resort, primarily when a patient is deemed a danger to themselves or others. However, recent data indicates these methods are overutilized, raising concerns about their impact on patient well-being.

In 2021 and 2022, NHS England reported that approximately 6,600 mental health patients were subjected to physical restraint, and around 4,500 experienced seclusion. Such figures suggest a persistent reliance on these harmful practices, which can lead to trauma, deterioration of mental health, and, in severe cases, death. Decades of research and advocacy have called for reducing their use, yet progress remains slow.

The historical use of restrictive practices dates back centuries, with early methods including binding, beating with rods, and confining patients in locked rooms. By the 19th century, mechanical restraints like straitjackets and restraint chairs became common, especially in British asylums. Despite recognizing their ethical issues in the 1830s, these practices persisted for many years.

The United Nations has long condemned such practices, recognizing them as human rights violations. In 2008, the UN's special rapporteur on torture highlighted that methods like solitary confinement breach international conventions protecting against cruel, inhuman, or degrading treatment. This position was reaffirmed in 2021, emphasizing that restrictive practices violate patients' fundamental rights, calling for urgent reforms.

Research shows that these practices not only cause direct harm but also contradict the core goals of mental health treatment. Many mental health issues stem from traumatic experiences that leave individuals feeling powerless and unsafe. Using methods that reinforce these feelings can worsen their conditions. There are documented cases where the use of restraint has tragically resulted in patient deaths.

To understand and address the roots of this issue, recent studies have developed models identifying key factors that sustain the use of restrictive practices. Emotional challenges faced by staff in high-stress environments, along with their decision-making processes influenced by fear and aggression, contribute significantly. Stress and emotional reactions like fear and anger increase the likelihood of resorting to restraint.

Given these insights, there is a growing interest in compassionate approaches to mental health care. Supporting staff emotionally and providing them with alternative coping strategies can reduce reliance on restrictive methods. One innovative approach involved implementing compassion-focused support groups for staff in forensic mental health wards. These groups aimed to help staff manage their emotional responses better and foster empathy for patients.

Early results showed that cultivating compassion among staff could diminish the use of restraint, creating a safer and more respectful environment for patients. This pioneering research underscores the potential of kindness and emotional awareness in transforming mental health treatment. Although change is gradual, such initiatives highlight a promising direction toward more humane and effective mental health care.

Ultimately, the goal is to replace harmful restraint practices with compassionate, patient-centered care, respecting dignity and human rights. Continued research and reform efforts are vital to making this vision a reality.

Source: https://medicalxpress.com/news/2025-07-physically-restricting-mental-health-patients.html