Inquest on restraint-related death opening…….

An inquest into restraint-related death of Kurt Howard will take place on the 27th May 2008. He was a psychiatric user on a section at the Cefn Coed Hospital in Swansea in 2002. His family has waited for nearly 6 years for this inquest.

The questions the family want answered is why Kurt was restrained for at least 55 mins (in the prone restraint position), how many times he was restrained before his death, was training adequate for staff and failure by staff to report Kurt’s death as restraint-related.

After the Inquiry into the death of Rocky Bennett in 2003, one of the recommendations was mandatory training for staff in the use of restraint. In the case of Kurt’s death, 3 assistants had taken part in the restraint including one psychiatric nurse. And that a patient should not be restrained in the “prone position for more than 3 minutes”.

There have been other restraint-related deaths in different state environments (police custody, psychiatric system, secure training centre) such as Rocky Bennett, Orville Blackwood (restrained in the face down prone position while forcibly given medication at Broadmoor), Roger Sylvester, Gareth Myatt and Azrar Ayub. A disproportionate number of Black people are on this list.

What is also shocking is that there is no statutory requirement to report instances of restraint nor a central database of restraint-related injuries or related deaths (Deaths associated with restraint use in health and social care in the UK, Paterson et al, 2003). Though a voluntary system is supposedly being established.

According to the Mental Health Commission, between 1997-2000 two mental health patients died while under restraint, four died within 24 hours of being held down and 22 died within a week. But how do we know if this is a true figure?

In guidance from the DoH (2000) they recommend that prone restraint should be avoided. Yet in the case of Kurt Howard, there was an excessive use of prone restraint.

As Inquest argue: “Excessive levels of restraint continue to be used in psychiatric institutions behind closed doors.  The government must enforce national guidelines and implement compulsory training on restraint before further vulnerable patients die.”

It is precisely the “behind closed doors” attitude, the injustices that go unheard, coupled with lack of training and guidance. And in many cases it is used due to non-compliance. People, for example, refusing to take their medication (and I have personal experience of that). And a perception that someone may be violent yet it is a baseless assumption, and institutional racism. People who are in state care, and in Kurt Howard’s situation on a section, have limited freedoms, basically their rights have been curtailed.

They are pretty much voiceless and powerless. And the state as a duty of care and time after time, inquest after inquest has shown a total neglect of duties and responsibilities. The excessive use of restraint exposes an appalling abuse of power and trust.

As Paterson et al argue in their review: “The most obvious way of reducing the risk of restraint-related deaths is of course to avoid restraint by actively promoting alternative intervention and management strategies that focus on primary and secondary prevention”.