Differences between restrictive practices applied to men and women in UK secure mental health services

Restrictive practices are intentional interventions used by mental health professionals with the aim of managing the risk of harm posed by patients, but have been associated with a number of harmful consequences for those who experience them. The current study aimed to explore differences in how restrictive interventions and restrictive practices more broadly were used between men and women who had been detained in secure mental health services in England and Wales, with the intention to inform policy and practice directed at developing gender-sensitive mental health services and to facilitate reduced use of restrictive practices. The sample for the study was 249 patients (203 men, 46 women) detained in low, medium, and high secure services in England and Wales. Analysis revealed significant differences in the way in which restrictive practices including observations, physical restraint, and restricted access were used with men and women. To our knowledge, few studies have previously set out to compare restrictive practices between men and women explicitly. Fewer studies still have considered the broader, day-to-day restrictive practices in place in secure mental health services. Our findings have implications for forensic mental health practice, research, and policy.