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PROD-ALERT: Psychiatric restraint open data-analysis using logarithmic estimates on reporting trends
Keith Reid1,2, Owen Price3
1Positive and Safe Care, Cumbria, Northumberland Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, United Kingdom.
Frontiers in Digital Health
|August 29, 2022
Summary
Restraint reporting in English mental health units remains inconsistent, despite Seni's Law. Analysis suggests significant under-reporting, with institutional size a key factor influencing restraint rates.
Area of Science:
- Forensic Psychiatry
- Health Services Research
- Mental Health Policy
Background:
- Inconsistent restraint reporting undermines regulatory oversight and data analysis in mental health services.
- The English Mental Health Units Use of Force Act 2018 (Seni's Law) mandates restraint reporting.
Purpose of the Study:
- To analyze open data on restraint use in English psychiatric and learning disability institutions.
- To assess the completeness of restraint reporting and infer under-reported rates.
- To identify factors influencing restraint reporting variations.
Main Methods:
- Analysis of open data from September 2020 to August 2021.
- Correlation of restraint incidents with bed days and legal detentions per month.
- Designation of 'complete' reporters and inference of rates for non-complete reporters based on institutional size.
Main Results:
- Strong correlations found between people restrained per month and bed-days (R²=0.90) and detentions (R²=0.78) among complete reporters.
- Significant under-reporting identified, with an estimated 1,774 people restrained monthly in England.
- Institutional size explained 90% of restraint variation in complete reporting institutions.
Conclusions:
- Restraint reporting in mental health facilities is significantly under-reported.
- Institutional size is a primary determinant of restraint variation.
- Comparing restraint rates per bed per month and using detention rates as a comparator are valuable for assessing reporting accuracy.
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