The psychological impact of restraint in acute mental health settings : the experiences of staff and inpatients

Restraint has been used as a method of managing untoward incidents in mental health practice since mental health care began. Although methods of managing untoward incidents have evolved over time, restraint remains to this day the principal model for managing violent and aggressive behaviour in acute mental health settings. Despite restraint being a dominant force in acute mental health care, the psychological impact of this intervention upon staff and patients is relatively unknown with very little research devoted to this area. Guidelines suggest that some form of Post Incident Review should take place following untoward incidents but this is patchy in many areas, and the efficacy of approaches to Post Incident Review has not been clearly documented in related literature. Furthermore, some staff and patients have reported that the experience of restraint triggers memories of previous traumatic encounters which have caused further distress to them during, and in the aftermath of, restraint. This study explores the psychological impact of restraint for staff and patients who are involved in these procedures. In addition, a framework for Post Incident Review is evaluated to establish whether this is a helpful tool to address some of the limitations of current approaches to Post Incident Review. The phenomena of restraint reawakening memories of previous traumatic encounters is also considered within the study to establish whether this has a bearing upon the experience of restraint for those involved in the procedure. The results highlight that the experience of restraint is distressing for staff and patients. The psychological impact ranges from minimal effects, to distress, through to full-blown Post Traumatic Stress Disorder (PTSD). The framework for reviewing incidents was well received by staff and patients and is offered as a way forward in providing a more structured approach to considering untoward incidents between staff and patients. This study has found that the experience of restraint does reawaken memories of previous traumatic encounters for both staff and patients. The study concludes with recommendations for education, further research and clinical practice.EThOS - Electronic Theses Online ServiceGBUnited Kingdo