The Mental Health Units (Use of Force) Act 2018 gives you extra protections around the use of restraint and isolation in a mental health unit.
It applies to all mental health units which the NHS runs or pays for.
However, only two duties apply at the moment:
- A duty on the government to publish legal advice (called statutory guidance). This will tell hospitals and others how to put the Act into practice. The government is under a duty to ask people their views about the draft statutory guidance before it is finalised.
- A power for the government to make legal rules (called regulations) connected to this Act.
** The Mental Health Units (Use of Force) Act 2018 does not change when restraint or isolation can be used. Restraint or isolation should only ever be used as a last resort and for as long as necessary. This is the law right now. **
This new Act aims to protect children, young people and adults from four different types of use of force. These are physical restraint, mechanical restraint, chemical restraint and isolation. The Act says:
- Physical restraint is “the use of physical contact which is intended to prevent, restrict or subdue movement of any part of the patient’s body”
- Mechanical restraint is “the use of a device which is intended to prevent, restrict or subdue movement of any part of the patient’s body, and is for the primary purpose of behavioural control”
- Chemical restraint is “the use of medication which is intended to prevent, restrict or subdue movement of any part of the patient’s body”
- Isolation is “any seclusion or segregation that is imposed on a patient”.
Article 39 worked on the Mental Health Units (Use of Force) Act 2018 when it was discussed in Parliament. We pressed for specific protections for children and young people, and we’re happy some of what we wanted is part of the Act.
Here are some of the important new protections which you will have when this new law comes into force:
- Your mental health unit must give you information about your rights connected to physical restraint, mechanical restraint, chemical restraint and isolation. This must happen as soon as possible after you are first admitted to the mental health unit. The senior person connected to your mental health unit (called the ‘responsible person’) must try their best to make sure you have been given this important information, and that you understand it.
- You and other patients must be asked your views when information about your rights and physical restraint, mechanical restraint, chemical restraint and isolation is being written. This is extremely important because you and other children and young people are the best people to say whether information written for you is understandable and answers your questions.
- The responsible person for your mental health unit must publish a document called a policy about the use of physical restraint, mechanical restraint, chemical restraint and isolation in your unit. This policy must say what staff who work in your unit will do to reduce the use of physical restraint, mechanical restraint, chemical restraint and isolation. This is incredibly important because restraint and isolation is meant to be used rarely.
- The Act says staff must receive training about the use of force. It sets out compulsory topics, including – showing respect to patients’ wishes and feelings; involving patients in care and treatment; making sure patients are safe; understanding the effects restraint and/or isolation can have on a person’s body, thoughts and feelings; and understanding how restraint and/or isolation can affect a person’s development. This is especially important for children, as harmful treatment earlier in life can have a very big impact on how a child grows physically and mentally. Staff must also receive training to make sure they don’t discriminate against patients or pick on and bully them. Training must include how to respect differences in people – this might be related to family and ethnic group differences or having different faiths and beliefs, for example.
- If restraint or isolation is used, staff have new duties to record information. This includes very important details such as – the reason for the restraint or isolation; where it happened; the name and job titles of staff involved; if anything was done to try and avoid using restraint or isolation; what happened as a result of the restraint or isolation; whether the patient was seriously injured; and whether the patient’s parents (or other important persons) were notified. We are especially keen for parents and carers to be told when a child or young person is restrained or put in isolation, so they can check you are OK. All of the unit’s records about restraint and isolation must be sent to the government – though not personal information about patients. Each year the Secretary of State for Health must publish a report which shows how often restraint and isolation has been used on patients and where.
- If police officers are asked by staff to come to your unit, the new law says that they should wear small cameras on their uniform, so there is a recording of how the patient is treated. The camera must record sound as well as a video.
This law could make a big difference to how well your rights are respected. That is why we want it to apply NOW.
If you are detained in a mental health unit, you have the right to help from an independent mental health advocate. Your unit may also have visiting advocates – these are people separate from the hospital or ward who can help you to be heard and protect your rights.