Restraint and restrictive intervention – consultation response

In 2018 we responded to the Department of Health & Social Care’s consultation on their draft guidance for reducing the need for restraint and restrictive intervention for children with learning disabilities, autism spectrum disorder and mental health needs. We welcome the aim to eliminate the inappropriate use of restraint and to develop preventative measures to support children and young people but recommend that the guidance includes more detail.

The Department of Health & Social Care's consultation is available online. It provides draft guidance for special education, health and care settings to support children and young people with challenging behaviour, reduce the risk associated with that behaviour and safeguard the wellbeing of children and young people in their care.

Restraint is defined as ‘using force or restricting liberty of movement’ and restrictive intervention is defined as ‘a deliberate act to restrict a person’s movement, liberty and / or freedom to act independently’.

Our response

  • We welcome the notion that the use of restraint should always be viewed as the last option, as children and young people have reported this experience to be traumatic and distressing.
  • We support actions to promote positive relationships and behaviour.
  • We welcome the guidance on individual care plans but suggest the detail of the plans is expanded. We support the notion that children and young people, and their parents / carers, should be involved in development of care plans.
  • We are concerned that the guidance is not applicable to mainstream educational settings, which encounter children and young people whose behaviour challenges. These settings are known to have high numbers of children with learning difficulties, Autism Spectrum Disorder (ASD) and mental health problems.
  • We are concerned that the guidance is not applicable to police settings, where increasing numbers of children are being subjected to restraint which may be harmful to their emotional wellbeing.

Our recommendations

  • The guidance should provide more detail of the content of individual care plans, including escalation plans, time frames to be adhered to and advice on when to use restraint techniques that are recommended and safe.
  • The guidance should outline the audit and monitoring processes that follow after the use of restraint. We recommend that any child or young person who has been subjected to a restraint procedure should receive appropriate follow-up support from a healthcare professional.
  • The guidance should be applicable to mainstream education and police settings.
  • There should be appropriate resources to adequately fund CAMHS and other children’s mental health services, to ensure children and young people have access to support.

We respond to a wide range of consultations to ensure that the College’s position, and ultimately children’s health, is represented. Members can get involved in current consultations by contacting the Health Policy team: