Thread by @Sectioned_

Thoughtful piece

Though yet again the point is missed that services do not only allow restraint & seclusion to be used as a last resort in response to emergencies ("imminent violence") - in some, it's routine

I was never, ever, in any way even remotely violent or even resistant

https://twitter.com/socratext/status/1605127107440300032

Once you notice it, it's there in every piece of research & writing on seclusion & restraint - the assumption that these are only ever used as a last resort in response to emergencies

But it's not true

Any & all work that is based on this assumption has failed from the outset

If an analysis/research does not acknowledge that, on some wards, the leadership & culture does not question, facilitates or even expects restraint & seclusion to be used in situations which are NOT emergencies, then it is flawed from the outset

What is the point of writing about the impacts of restraint & seclusion on staff & patients if there's no acknowledgement that they can be used as routine practice?

A culture where these grossly coercive practices are used in this way negatively impacts on both staff & patients

What's the point of hand-wringing by professionals "shocked" at abuses on inpatient psychiatric wards which doesn't even acknowledge that abuse can include use of restraint & seclusion?

In my case, the multiple restraints I was subjected to are inexplicable on any sound basis

There is no justification whatsoever

I was wordlessly ambushed, restrained, forcibly injected - once, when I'd stepped out of a meeting with my IMHA to get a letter she'd requested!

There was not a single occasion of restraint or seclusion to which I was subjected at the hands of qualified #mentalhealth staff which was justified or followed the Mental Health Act code of practice or any of the professional duties of the staff involved

Yet they all took part

All these members of staff took part

The ward manager took part (she led the first ambush restraint - I was sitting in bed, reading)

The manager of the rapid response team took part (he led the team that carried me face down & shoeless into the seclusion room on the men's ward)

All the staff took part

They did not speak to me, but coordinated with each other - one on each limb, one holding my head, one to oversee - as if I were an animal

I talked to them throughout, but they ignored me

For them, this was business as usual - a routine job to be done

Imagine going in to work to do that to other human beings

I've had staff contact me on twitter about abusive cultures that take hold, where this is normalised, where those who try to speak out are the ones who are bullied out of their jobs

Imagine the effect on poorly patients

The "closed cultures in inpatient mental health services" can't begin to be addressed unless it's acknowledged that those closed cultures can and do - now, today - use restraint & seclusion in abusive ways

The way I was treated by inpatient psychiatric staff while sectioned caused me to develop post-traumatic stress disorder

The years since then, without treatment for #ptsd, have compounded the harm caused to me

Think carefully before using restraint or seclusion

Very carefully