Positive and safe care – Restrictive interventions

Positive and safe care to prevent challenging behaviour and the need to use restrictive practices.

Our hospital wards are designed to be safe, supportive and caring environments to help you on your recovery journey. Staff are trained to prioritise your mental and physical wellbeing while upholding your Human Rights. 

This leaflet provides information for you, your family, carers and others important to you about when staff may legally use force in mental health settings. It also outlines what our trust is doing to prevent and reduce the use of force, in line with the Mental Health Units (Use of Force) Act 2018. Co-produced our staff and service users, this leaflet aims to ensure force is only used when necessary, and always with transparency and accountability. 

What does ‘use of force’ mean? 

‘Use of force’ refers to actions taken by staff to restrict a person’s movement or behaviour to prevent harm. This can include: 

• Physical restraint – holding someone to limit movement 
• Mechanical restraint – using devices like handcuffs (only in secure services during high-risk transfers) 
• Chemical restraint – administering emergency medication to reduce distress 
• Seclusion – caring for someone separately from others for a short time, under supervision 
• Segregation – keeping someone in a designated area of the ward for a fixed period 

These measures are short-term and used only when necessary to prevent harm. Staff are specially trained to avoid using force wherever possible and are legally required to respect your rights under the Human Rights Act 1998, Mental Health Act 1983, Mental Capacity Act 2005, and Equality Act 2010. Reasonable adjustments must be made for individuals with disabilities, including learning disabilities. 

Why might force be used? 

People come to our hospitals with a wide range of needs. Sometimes, distressing emotions like fear, anxiety or anger can become overwhelming and lead to behaviours that may risk harm to themselves or others. 

In such situations, staff will first try to calm and support the person through conversation and de-escalation techniques. If these approaches don’t work and safety is at risk, staff may need to intervene. 

When is force used? 

Force is only used as a last resort when there is no other way to keep people safe. Staff are trained in de-escalation and trauma-informed care and will always aim to reassure and protect the person involved. Any use of force is carefully recorded in the person’s medical records, including what happened before, during and after. 

Force must never be used to punish, enforce rules or cause pain or injury. Everyone is treated fairly, regardless of background or beliefs. 

What happens afterwards? 

Once the person feels ready, staff will talk with them about what happened. This helps identify triggers and explore ways to prevent similar situations in the future. The person can ask for a family member, friend or Independent Mental Health Advocate to be present during this conversation. 

If there are concerns about how force was used, the situation will be reviewed by the care team. 

What are we doing to reduce the use of force? 

Our trust has developed a co-produced positive and safe strategy with four key objectives: 

1. Back to basics 
2. Co-production 
3. Ending floor-based restraint 
4. Safe and functional environments 

All staff receive mandatory training focused on avoiding the use of force, using de-escalation techniques and understanding trauma and human rights. Service users help design and deliver this training to ensure it reflects real experiences and needs. We also run quality improvement projects to better understand and reduce the use of force.