Data and the Mental Health Units (Use of Force) Act

It has been nearly six months since the Mental Health Units (Use of Force) Act came into force, and 12 years since the tragic events that were the catalyst for the legislation.

This act is really important as it has the potential to significantly reduce the use of restrictive interventions and, by doing so, improve people’s care. We know from our ‘Out of sight — who cares’ report (Out of Sight — Who Cares?), just how devastating the consequences of restraint, segregation and seclusion can be on people’s lives.

In this blog I will focus on data and how vital it is to the rest of the act’s provisions. But first, a reminder about the aims of the act and the events that led to its inception.

Olaseni (Seni) Lewis died after he was restrained by police at Bethlem hospital, South London in August 2010. His family campaigned tirelessly on the issues surrounding his death. They worked with their local MP, Steve Reed, to introduce a private members bill, which subsequently received government and cross party support.

The bill, often known as “Seni’s Law” in memory of Olaseni, became an Act in 2018.

The Act aims to clearly set out the measures which are needed to:

• reduce the use of force, including restraint (force used to prevent or make someone do something) and enforced isolation (seclusion and segregation)
• ensure accountability and transparency about the use of force in our mental health units.

The Act requires mental health units to publish data about their use of force. They do this by submitting a record of their use of restraint and isolation to NHS Digital’s Mental Health Services Data Set. The data provides a public record of force used by mental health units, which increases accountability and transparency.

The data does much more than that though.

It will be essential for providers when they review and update their policy on the use of force, as required by the Act.

Crucially, the statutory guidance says that providers must develop these policies with patients and the communities served by the mental health unit. These groups will be able to use the published data about the use of force — and how it compares with other units — to hold their local service to account.

The resources available to inform policies on reducing the use of force typically require a thorough understanding of the data. Some of the resources we expect to see providers using include:

• Safewards
• Towards Safer Services
• Six Core Strategies

Data on the use of force will also improve the training provided for staff in mental health units. The Act says that staff must be given appropriate training. The statutory guidance says that the training must comply with the Restraint Reduction Network’s training standards.

The standards require input from people with lived experience, and we know that their input can only be stronger if they know the provider’s record on the use of force, what their policy says and how effectively it is being implemented.

CQC, along with people who use services, their families/carers, commissioners and other regulators will all be paying close attention to the data published by NHS Digital.

It is too early to draw conclusions from the published reports for April (NHS Digital, Mental Health Services Monthly Statistics — Restrictive Interventions), except to say that we will be working with providers who are not yet submitting data.

In the following months everyone will be able to find out which providers are successfully reducing their use of force, reducing the number of times that people are subjected to restrictive practices. We will be able to learn from the approaches they have taken, and we will share what we find to help others improve. Alongside our system partners, we’ll also be able to offer support to organisations who aren’t making progress.

We look forward to seeing improvements in this area going forward and will continue to update you on this.