Olivia Blake Member of Parliament for Sheffield Hallam
Last year, a parent wrote to me to tell me they were struggling to secure a mental health bed for their child, who had been diagnosed with anorexia and needed urgent in-patient care. But because no specialist tier 4 beds were available, they had to be admitted to a general ward instead. When they first contacted me, their child was being restrained most days to be fed. The parents were worried that without specialist support, repetitive restraint was only making things worse.
I have since spoken to numerous eating disorder specialists, researchers, and medical staff who have all told me about the rising number of children with eating disorders being restrained by staff in general medical wards without training.
And I have heard more first-hand stories.
One person told me that at 17 years old, they were restrained for feeding via a nasogastric tube three or four times a day by five people. This went on for ten months.
Another person told me they had been restrained for daily NG feeds by five to six staff at a time for six months. Sometimes they were held for up to an hour afterwards and would come out with bruises, despite their screams during the restraint.
A 17-year-old young woman told me that restraint was the first port of call to calm her and other patients – sometimes by up to eight members of staff. She was restrained in the shower and told that they would have to fetch male staff if she did not calm down. Even now she has traumatic flashbacks.
I have heard other stories of 15-year-olds being restrained at eleven o’clock at night for nasogastric feeding.
To be clear: it is not just that the people I have described are suffering because they are having to wait to access the care they need. That is bad enough. But what is shameful is that the settings in which they have been placed while they wait are actively contributing towards the deterioration of their mental health.
The use of restraint and restrictive intervention is now widely recognised to have long-term consequences on the health and wellbeing of patients, as well as a negative impact on staff who carry out such interventions. That’s why the Department of Health guidance states that restraint by medical professionals should only be used in life-threatening situations and should be minimised across all adult health and social care settings.
Restraint on mental health wards is regulated – staff are required to keep records of when it is used. Bizarrely, the same is not true for general medical settings, so it’s hard to get a scale of the problem. But frankly the stories I have recounted should speak for themselves.
In February, in a Westminster Hall debate, the Minister told me that they were concerned to hear about it. Since following it up in writing I have received a letter indicating the Government intends to take no action either to investigate the issue or to ensure we have proper scrutiny of when restraint has been employed in a general medical setting. That is disgraceful.
Medical staff have an extremely difficult job to do in increasingly challenging circumstances. Good practice in reducing the use of force does exist, and we should learn from it. For example, in my own city, Sheffield Children’s Hospital has started recording the use of restraint in general medical wards already. That is extremely positive. But for actions like these to become common practice, proper resources need to be put in place, with proper staffing levels, and training.
The people whose stories I’ve told have waited long enough. It’s time we invested in our staff and our NHS to ensure that everyone receives the treatment they need when they need it – and that Ministers took some responsibility for investigating and monitoring the consequences of their under-resourcing of mental health services.
You can watch my speech here and read more about the campaign here in my piece for the Yorkshire Post.
On the Public Accounts Committee, I questioned NHS and DHSC officials on the issue of restraint and also the worrying reports that guidance relating to medical emergencies in eating disorders is not being followed.
I have also been elected as a vice chair of the APPG on Eating disorders and hope to continue to campaign on improving services for both patients and staff.