Children and Young People: Restrictive Intervention

Steve Reed Excerpts

Thursday 25th April 2019 Commons Chamber

[Mr Steve Reed (Croydon North) (Lab/Co-op)]

I congratulate the right hon. Member for North Norfolk (Norman Lamb) on securing this important debate, and on the powerful case that he made. I am sure the whole House would pay tribute to him for the progress that he has led in improving conditions for people with mental ill health over many years. Personally, I thank him for the support and advice that he so generously gave me during the passage of Seni’s law last year.

The use of restraint and excessive force is one of the most pressing issues for children who have experience of secure mental health units. Restraint is humiliating and degrading for children, as it is for adults. It can undermine their recovery and can make the child’s mental health condition worse.

There have been too many tragic incidents where children and young people have been seriously injured—even killed—because of excessive restraint. Seni’s law came about in response to the horrific death of my constituent, Seni Lewis. Seni, who was just 21 years old, died following severe and prolonged face-down restraint in a seclusion unit in a mental health hospital, when up to 11 police officers took it in turns to pin him face-down on the ground with his hands cuffed behind his head and his legs in shackles. That triggered a heart attack, which put him into a coma, and he was left to die all alone in a room, tied up face-down on the floor. Seni’s tragic story is just one of too many deaths and scandals, including Winterbourne View, Southern Health, St Andrews and many others that Members will be familiar with.

It is shocking that children are more likely to be restrained than adults. According to the leading mental health charity Young Minds, children under the age of 20 are four times more likely than adults to be restrained face-down, three times more likely to be tranquilised and twice as likely to be put in handcuffs or leg braces. Although children are less likely than adults to be secluded, it is surely unacceptable that any child with mental ill health is ever locked up all alone in a seclusion room.

I was grateful for the huge support from across the House for Seni’s law, which became an Act of Parliament last year. It introduced some important principles into law that now need to be extended to protect all people with mental ill health, including children, in every setting, not just mental health units, to which that piece of legislation applied. Those principles are intended to reduce the use of restraint, so that it is only ever used as a very last resort and face-down restraint is never used at all.

The mental health system needs to be fully transparent. There is wide regional variation in the use of restraint against children, but we do not know why, and data is not available for us to interrogate. The campaigning charity Agenda reports that in some mental health trusts, three quarters of children are restrained, while in others it is none at all. If some trusts can completely avoid the use of restraint against children, why can every trust not do so? We need a standardised national system for recording the use of restraint, so that we can compare like with like, identify best practice and ensure that it is shared, and allow us and other observers to fully interrogate and scrutinise the system to ensure that it is supporting and not harming some of the most vulnerable children in our society.

Half of all girls with mental ill health have experienced some form of abuse, either physical or sexual, that affected their mental health. The use of restraint against them—especially being pinned face down on the floor by men—reawakens the horrific abuse that made them ill in the first place, which can mean that they leave care with worse mental ill health than they arrived with. That surely cannot be acceptable.

The second important principle is accountability. All mental health settings need a policy in place for restraint reduction, with appropriate training to ensure that restraint is avoided whenever possible. They need a named senior person who is publicly accountable for how restraint is used, so that there is clarity about who is ultimately responsible for what happens in that setting.

Despite Government attempts to discourage it, the most dangerous form of restraint—face down on the floor—was used against children more than 2,500 times in the most recent year for which data is available, yet that form of restraint is not supposed to happen at all. The current system clearly is not working. The deaths, injuries and psychological damage that excessive restraint causes to children must stop. I hope the Government will ensure that the important principles enshrined in Seni’s law and the important work undertaken by Sir Simon Wessely’s mental health review are used to protect every child who experiences mental ill health.