Physical restraints in the NHS

Prevention Management of Violence & Aggression ( PMVA) is a five day course designed for those working with the learning disabled and the mentally unwell.

It is offered by Train Healthcare, a training company set up to offer both face to face and e-training to governmental and private healthcare commissioners.  I think the word `care` is being used quite liberally here.

Learners have to adhere to the training safety requirements and the dress code for the course. Fingernails are to be short and no belts and buckles are to be worn because the techniques require physical contact.

There is a long list of topics including: Hierarchy of Responses
De-escalation
Risks in Restraint
Deprivation of Liberty Safeguards
Human Rights Act 1998
What is torture? The last item is particularly enlightening.

Teamwork provides an even longer list of skills to be achieved and here is a sample: Figure of Four
Thumb in Palm
Finger & Thumb
Re-location to the Floor Supine
Securing the legs
Relocation to the floor prone: Now these techniques are to be used to manage those with learning disabilities and mental health issues, the most vulnerable and socially disadvantaged of all, who will probably be in a place not of their choosing. If they are showing signs of aggression that is probably an indication that something is wrong. Is the young person in pain, for example, but unable to communicate his distress? Has the woman misunderstood the situation because she is lost in world of mental disturbance?

If so, the last thing patients need in this already restrictive situation is to find themselves pinned to the floor unable to breathe.

That would be torture.

Having watched the Panorama programme about abuse in a juvenile detention centre where grabs and holds were used to bully teenagers, it is very concerning that so-called `carers` are thought to require five days of this type of training. Need we wonder why these facilities have so many unexplained deaths.

http://www.trainhealthcare.com/pmva-5-day/

The Restraint Reduction Network

"There is widespread concern that such approaches are not always used as a last resort, are misused or abused, and represent a potential breach of human rights—particularly when used with individuals who are unable to speak out about their experiences."

http://restraintreductionnetwork.org/