Mental Health Local Programme

Understanding the use Mechanical Restraint in High Secure Settings

East Midlands Alliance for Mental Health Learning Disabilities and Autism (EMA)  are a Mental Health Alliance made up of the six largest mental health organisations in the East Midlands. Find out more about EMA here. The EMA together with NHSE (Midlands) Specialised Commissioning team for Mental Health commissioned HIEM to take a human factors approach to understanding the use of mechanical restraint in the four high secure hospitals in the UK.  

This work aimed to understand when and how mechanical restraint is used, including the barriers and facilitators, and the reasons for any variation between units. By using a Human Factors approach we considered the whole system and the interactions between people (staff and patients), the tools used, and the environment.  This is NOT part of any inspection or judgement process.  

Image: The SEIPS framework that HIEM are using throughout the programme.

systems engineering initiative for patient safety

The results will support shared learning, further discussions, and improvement work by the EMA, NHSE (Midlands) Specialised Commissioning team for MH and the high secure units that can support the co-creation of good practice guidance for mechanical restraint.

What the workstream involved

The work had a number of different elements including:

  • A literature search – available to view here
  • Data analysis of restraint types
  • Process mapping
  • Interviews with Governance leads, mechanical restraint trainers and ward leads.
  • Focus groups with staff
  • Usability testing of mechanical restraint kit
  • Clinical notes review
  • Patient survey
  • Use of a human factors framework to support analysis

The wider programme of work started in March 2023 and lasted two years. The information was collated into a final report.

Outputs

Learn more about Human Factors

 

Further information

If you have questions relating to this workstream then please contact This email address is being protected from spambots. You need JavaScript enabled to view it.