What are the risks of prolonged restrictive interventions?

James Hourihan, Author

Under certain circumstances, physical interventions are part of providing care for individuals who present challenging behaviours and are potentially at risk to themselves or those around them. While these may be deemed necessary, there is strong evidence that excessive or prolonged use of restrictive interventions can lead to some serious traumatic, adverse effects. 

What are Restrictive Interventions? 

Restrictive interventions can refer to any physical and chemical measures used to limit a person’s rights and freedom of movement like straps, cuffs, vests, tranquillisers and sedatives. Over the years, there has been an over-reliance on these interventions to take immediate control of situations. 

Latest figures from NHS Digital revealed that in June 2022, there were 3,815 reported uses of restrictive interventions. During the same period, an inspection conducted by CQC found high levels of restraint, seclusion and segregation at Lanchester Road hospital, where six patients had restrictions imposed upon them that were not proportionate to risk, with no clear rationale. 

Furthermore, an alarming number of instances show restrictive interventions and prone position holds being used to inflict pain, humiliate and punish service-users for extended periods of time, according to campaign findings from mental health charity Mind

It is clear that staff supporting children and adults with mental health conditions, learning disabilities, autism or dementia need to receive qualified training in order to understand the risks associated with prolonged restrictive interventions and minimise restrictive practices in order to keep everyone involved physically and psychologically safe throughout, as well as beyond this process. 

Risks Involved with Prolonged Restrictive Interventions

Physical Injury 

The most common risk associated with restrictive interventions is physical injury. People who are restrained face increased chances of cuts, bruises, sprains, fractures, and other injuries due to their inability to move during the procedure. Furthermore, they can cause sensory deprivation due to lack of stimulation from their environment.

There is also a heightened risk of suffocation or strangulation if the restraints are too tight or applied incorrectly. People who have existing medical conditions such as asthma can experience an exacerbation or positional asphyxia due to restricted airways caused by prolonged intervention techniques.

 Psychological injury 

Another risk of prolonged restrictive interventions is psychological trauma such as fear, anxiety, depression and post-traumatic stress disorder (PTSD). The person may also become overly dependent on the care they receive while under restriction, which could eventually lead them to develop learned helplessness—a state where they no longer attempt to take simple actions that could improve their situation, even when those opportunities are possible. 

Decrease in Quality Of Life  

Naturally, both the previous risks of restrictive techniques result in a decrease in quality of life. When people are constantly subjected to restraints or other sources of control for long periods of time, their sense of autonomy starts to diminish. This can lead to disbelief in one’s own abilities or self-worth that impacts day-to-day living, as well as future prospects for success and independence.

Additionally, these individuals may face challenges in forming meaningful relationships with others due to social limitations and feelings of mistrust or fear stemming from their traumatic experiences with physical restraint.  

Legal Implications 

Finally, there are legal implications associated with prolonged restrictive interventions that should be considered before implementing one on any individual. These include potential lawsuits against staff and the organisation responsible for their care from patients claiming negligence if they suffer an injury, as well as civil rights violations if the person’s rights were infringed upon during the process itself (i.e., excessive force).

Training in Positive Interventions 

As you can see, restrictive interventions could have long-lasting consequences if not managed correctly. Our ethical approach is focussed on understanding behaviour in order to create positive outcomes for educational, social care and health care settings. 

We provide BILD Act certified positive behaviour management training to ensure sufficient support systems are put into place with de-escalation and positive handling techniques delivered in the context of reducing restraint as much as possible. 

For information, please get in touch on 0800 987 4075 or fill in the form on our website to start your journey with Timian. 

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