Petition: Bring back the mental health inpatient survey
[Trigger Warning: Involuntary hospitalization, medical abuse, unsafe restraint, PTSD]
HANG ON. this man was not physically restrained unless there was a reason to do so. physical restraints aren’t used unless it is the LAST possible thing you can do to gain control over the patient.
“The nurse must adhere to hospital policies regarding restraint. A physician’s order is necessary for a restraint, and nurses should document all of the previously tried de-escalation interventions before the application of restraint. Nurses should limit the use of restraints to times when an individual is judged to be a danger to self or others, they should apply restraints only until the client has gained control over his or her behaviour.” - Psychiatric and Mental Health Nursing for Canadian Practice
the attempt was to control the patient using chemical restrains (injection) which made the client more agitated so he acted out, which called for the use of physical restraints to gain control so the chemical restraint could be given. that’s how i’m assuming this went. if they used physical restraints for no reason, they would have a lawsuit on their hands, and i’m assuming they don’t….because they used physical restraints as a last resort.
NOW. the fact that it triggered a memory of childhood abuse is beyond the staff’s control. staff has no reason to know anything like that will happen unless something is documented so that they are aware of a person’s complete history, which i’m assuming they didn’t.
and once again, THEY WOULD NOT HAVE USED THE PHYSICAL RESTRAINTS UNLESS THE CLIENT HAD ESCALATED TO A POINT WHERE HE NEEDED TO BE CONTROLLED.
What this man is describing is prone restraint, and it’s potentially lethal.
Regardless of what you think about the particulars of this account, Rethink have cited this man’s experience on the petition page because there’s no system in place any more for the Department of Health or NHS to keep a record of these kinds of voices and accounts, and it’s coming down to charities like them to collect peoples’ feedback about how they’re treated in inpatient settings. The opportunity this creates for abuse to go unnoticed is very disturbing.
So you’re refusing to back an important survey that allows mental health inpatients’ voices to be heard because you’ve determined that this guy must have deserved prone restraint? Wow.
I was interested to read on your blog that you’re a trainee psychiatric nurse. With your response to this petition and the number of times you cited “control” in your response I’m sure you will be quite an asset to the profession.
Physical restraints are hypothetically supposed to be used as a “last resort.” But as the last several decades of mental health care have shown us, that is simply not reality. Restraints have been (and will continue to be) used as a means of threatening, silencing, controlling, and even punishing the most vulnerable of patients. Taking away their chance to voice what has happened to them will only increase the potential for abuse. Taking away what should be an essential safeguard simply because you find it inconvenient or “irrelevant” is indefensible and quite frankly terrifying to me.
Your complete lack of empathy for this particular man’s experiences is also alarming. Why do you assume that the staff was unaware of his childhood abuse? Given the rates of history of trauma/abuse in the inpatient mental health population, it should automatically be assumed that physical restraints pose a threat to the well-being of all patients. It should be automatically recognized that restraints pose an enormous risk for triggering flashbacks and recurrence of PTSD symptoms in anyone with a history of trauma or abuse. And again, given the rates of such histories in the inpatient population, it would be far safer to assume a patient might have such a history and thus avoid tactics that risk further traumatizing such a patient. Claiming ignorance of the person’s particular history is not a defense for using unnecessary and high-risk “treatment” methods.
As ever, this issue is illuminated far better by a follower than me. I think the point you raise about empathy is a really important one: operating under a language of control as opposed to understanding and concern is alarming in mental health professions, and can often contribute to escalating situations into avoidable ‘stand-offs’ with physicians.
Also, you’re absolutely right: though it might say in textbooks and rulebooks that restraint should/is only used as a ‘last resort’, in real life this just isn’t the case. Restraint is used routinely with vulnerable individuals with mental health diagnoses and intellectual disabilities as a ‘go-to’ response to behaviours that challenge (e.g. Emerson (2003) suggests that over 50% of people with intellectual disabilities and challenging behaviour are regularly exposed to restraint.) Disregarding someone’s account of their personal experience because it doesn’t match up with what the rulebooks say on the issue is a form of silencing: plain and simple.
I can’t stress how important it is that we all sign this petition to try to bring the mental health inpatient survey back. We need to hear the voices of people in inpatient settings: we need to know what treatment they are exposed to and what they think about this. The mental health profession cannot improve without listening to the people it cares for.