This year’s World Mental Health Day 2022 theme is to make a global priority of mental health and wellbeing. It’s a good theme, and much needed, but at the same time, I’m frustrated that society at large seems so very far away from understanding, let alone acting, upon this objective. There is fantastic work being done by charities and on an individual level, but we need governments and employers, service providers, and managers to make it their priority too, not just announce initiatives that get sidelined when they become inconvenient or too costly. This goes double for those whose role it is to protect and treat highly vulnerable people.
For many, the choice is not theirs
While all this good work is happening, many others, children, in particular, have no option but to hope those in positions of responsibility — teachers, hospital staff, residential home staff — act appropriately to support their well-being. We hear too many stories — one is too many — where this doesn’t happen. Restraint happens every day to children and young adults in both mainstream and specialist settings. It happens to children in care settings, and to highly vulnerable people who are inpatients in mental health treatment units.
In just one week there has been an article in the Guardian concerning the restraint of children in a special needs setting as well as the investigation from BBC Panorama, highlighting the iatronegic harm being inflicted on highly vulnerable people. I was horrified by both but sad to say, neither shocked me.
There are some fantastic places out there with dedicated staff, but every week hear about those who should never be anywhere near vulnerable people, where physical restraint and enforced isolation seem commonplace. Restraint is abuse that traumatises those subjected to it. It is preventable and must stop.
And while you may think this happens only away from the public eye, our readers will tell you differently. The quotes throughout this article are from parents (used anonymously) whose children have experienced restraint in mainstream and specialist schools.
“Two of my kids have had to have therapy to recover from the trauma caused. More protection for adult prisoners than children in school.” Parent
“We're still traumatised from our experience of..[our child’s] school Still, according to their governors it's only restraint if it involves two adults pinning a small child to the floor. The fact restraint would never be necessary if they supported children appropriately instead of denying referrals and refusing to acknowledge a child is struggling is apparently too difficult for them to grasp” Parent
“This happened to our little boy. A headteacher in a mainstream school restrained my boy in front of me and two weeks later she left the school for a new job - my son’s teacher was trying to cover it up later in the day saying “they can’t restrain”. Many more incidents happened without our knowledge- they are all covering their own backs these people…our kids mental health is more important. I homeschool my kids now and I am not alone - many more parents are taking their kids out of school for the same reason.” Parent
New guidance on the way on restraint— but too late for too many
It is hard to believe that those perpetrating restraint ever think it is acceptable or the only option. How do we prevent it? How do we stop individuals and families being traumatised and living with the trauma this causes? There is some action—recently, following an EHRC inquiry into the use of restraint in schools in England and Wales, the Department for Education confirmed it will provide new guidance on restraint in schools to promote de-escalation practices and for recording of physical force to be mandatory with a legal duty to inform parents when it has been used.
Nevertheless, what is utterly heartbreaking is hearing from the individuals and families who are directly affected by this abuse and the trauma it causes, both individually and vicariously. The power imbalance between practitioners and children and vulnerable adults makes it almost impossible for them to complain. They are often disbelieved or gaslighted—told they’ve ‘misconstrued or exaggerated’ what happened. Families who want to help can feel equally as powerless, or even blamed.
“Seems to be standard practice in specialist schools in [our LA]. Use physical restraint then segregate them from their peers to cause maximum trauma then claim ‘we tried’ or the old classic of blame the parents!” Parent
“My son was put in a room with a couple of cushions and locked in! And four grown men surrounded him once when he was struggling. Got him out of that mainstream immediately” Parent
“My grandson is still traumatised at 15 by the treatment he received in primary school. The people doing this and those who let them should be named and shamed. I wouldn’t let the SENCO of that school look after animals let alone vulnerable young children.” Grandparent
“This happens all over the country in mainstream schools too. As parents we have no rights over whether or not someone restrains our children, my LA publish their own guidance and the DfE has theirs too which basically says we have no rights! But if we were to do it to an adult we would be arrested for assault. Teachers aren’t allowed to give comfort to our children in the form of a hug when they need it, but they are allowed to pin them in a front ground (that’s head facing the floor) hold! Where’s the sense in that? As a [mainstream] teacher, I witnessed staff who made it clear they are not in agreement with the practice of restraining children have eyes rolled at them, be ostracised by the senior leadership team, then labelled as troublemakers. Eventually, the environment becomes so toxic they have to leave.” Parent/teacher
More than guidance is needed
We must continue to spotlight abuse, however uncomfortable for onlookers, because without real accountability and training, how else will mental health and wellbeing become a global priority for all? Our most vulnerable in society deserve nothing less than this.
We need to be able to ensure that strict procedures are in place, adhered to, and that when things go wrong, they are investigated independently, thoroughly and fairly. We must ensure that victims/patients are believed and provided with appropriate help and support. Whistleblowing staff must also be protected so they are empowered and feel compelled to act if they see abuse happening. Most importantly we need to educate and inform everyone about consent, so patients know what is happening to them is abuse, for staff know that restraint is abuse, and for bystanders know that doing nothing is the same as allowing abuse to continue.
If behaviour breeds behaviour, then let’s make it that we are following behaviour that treats people with dignity and respect and ensures they are cared for. Being consistently cared for, validated and treated with humility is the greatest healer.
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