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Implementing the national objective to end Prone/Face Down Restraint

Eric Baskind Senior Lecturer in Law and International Expert on Physical Interventions Liverpool John Moores University opened today’s Prone/Face Down Restraint conference with background information to set the context of the day.


MIND’s 2013 report noted that “Physical restraint is linked with death, and people with mental health problems continue to experience excessive force, physical injury and psychological harm in psychiatric settings. Continuing to leave the practice of physical restraint unchecked and open to variation in England, and failing to put an end to the use of face down physical restraint is unacceptable.”  

The Report of the Special Rapporteur (United Nations General Assembly, February 2013) went even further and demanded “an absolute ban” on restraints and seclusion.

There have been many good initiatives aimed at reducing the use of restraint across healthcare services. However, despite these well-intentioned initiatives the use of restraint remains problematic with a significant number of restraint-related deaths and injuries still being reported. 
On 3rd April 2014 the UK’s Department of Health issued important new guidance on the use of restrictive physical interventions. The Care and Support Minister, Norman Lamb MP, explained that “No-one should ever come to harm in the health or care system. Although it is sometimes necessary to use restraint to stop someone hurting themselves or others, the safety of patients must always come first. This new guidance will stop inappropriate use of all types of restraint, reduce this outdated practice and help staff to keep patients safe. The new guidance forms part of a two-year strategy to overhaul the outdated use of restrictive interventions, such as face-down restraint, seclusion and rapid sedation, in all health and care services.”
A key part of this new guidance concerns the use of prone restraint positions. Paragraph 70 states that “there must be no planned or intentional restraint of a person in a prone/face down position on any surface, not just the floor.” This guidance should be read alongside the 2015 Mental Health Act Code of Practice which restricts the use of prone restraint to situations where there are “cogent reasons” for using it. 
Which document takes precedence? Some organisations have imposed a ban on the use of prone restraint. But, is it wise to ban the use of any intervention that could, in appropriate circumstances, be used in the best interests of the patient? What was the cause of the debate? Can it really be banned? What are the alternatives? What are the consequences? These are some of the issues I will be addressing in my presentation. 

Erik’s full presentation is available for download at the end of this page.

Eric Baskind has been active as a consultant in the prevention and management of violence and aggression and in the use of physical interventions since 1987. He is also a senior lecturer in Law at Liverpool John Moores University where he is responsible for teaching a number of subjects including criminal law, sports law and commercial law. He is a Fellow of the Higher Education Academy, a Member of the Society of Legal Scholars, a Member of the Chartered Institute of Arbitrators and a Member of the European Violence in Psychiatry Research Group. He is Chairman of the Centre for Physical Interventions at the British Self Defence Governing Body (BSDGB), a not-for-profit organisation dedicated to the improvement in personal safety and to the reduction in violence and aggression in the workplace. 

Eric has advised numerous organisations on the use of force and physical interventions and has been instructed as an expert witness both in the UK and in other countries in more than 3,000 cases involving restraint-related injuries and deaths including by the Prison Officers’ Association, Police Federation, Home Office/Ministry of Justice and the Scottish Prison Service. Amongst the other organisations he is currently advising are the High Secure Hospitals at Ashworth, Rampton, Broadmoor and Carstairs where he is Expert Advisor to the HSS Violence Reduction Manual Steering Group and the Security Industry Authority where he chairs an expert panel reviewing the management of violence and aggression and use of force in connection with the SIA’s licence-linked qualifications. Eric has also recently been invited to join the Mental Health Restraint Expert Reference Group on behalf of the Metropolitan Police and College of Policing. 

Forthcoming events of interest:

Implementing the national objective to end Prone/Face Down Restraint: Examining Restraint Positions in Practice
Tuesday 21 April 
ICO Conference Centre, London

Masterclass: The Legal use of Control and Restraint
Thursday 14 May 
Hallam Conference Centre, London


Psychosis & Schizophrenia in Adults
Monday 8 June 
Hallam Conference Centre, London

Improving Physical Health for People with Mental Health Conditions
Monday 14 September 
Hallam Conference Centre, London

Implementing the national objective to end Prone/Face Down Restraint: Examining Restraint Positions in Practice
Tuesday 22 September 
ICO Conference Centre, London

Download: Erik Baskind full presentation

21 April 2015


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