Since june of last year I have been busy leading a consultation process for the DH which culminated in a guidance document being launched by Care Services Minister Norman Lamb on the 3rd of April. Its all about reducing restrictive interventions. I guess most people will think of restraint , but its more than that . it can embrace physical but also chemical processes and the most common such as environmental. That's very much about practices such as blanket security processes such as locking areas, denying access to places (kitchens etc) and just being inhibited in what you can do.
But why have these practices crept into place. Its been a 300 year old debate about the balance between freedom and autonomy and the risk to self and others when in places of care and treatment. It remains a distinctive feature of mental health services that we have the ability to compel and coerce and also have a client group that at times wishes to not only endanger others but also themselves to the point of destruction.
I have met many people in this process over the last year that are really trying to do the right thing by those they care for and yet seem frustrated by what they are required to do and also the environment of scrutiny and resources allocated for their role.
Its been a 300 year old journey, but still far from over.
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