Mental Health Units (Use of Force) Act 2018 (Seni’s Law) by Emma Bergin

The much anticipated Seni’s Law has now been enacted and related guidance published. The Mental Health Units (Use of Force) Act 2018 (“The Act”), known as Seni’s Law, aims to protect mental health patients from disproportionate and inappropriate use of force while they receive in-patient treatment in mental health units. The Act will come into force on 31 March 2022.

Mental health units are permitted to use various methods of force in certain circumstances. In addition to physical restraint, the definition of force under the Act also includes the use of devices to restrain a person (mechanical restraint), the use of medication (chemical restraint) and the use of isolation (including seclusion and segregation). Force should only be used in a way which respects a person’s human rights - it must be necessary and proportionate.

What does The Act require? 

The Act sets out a number of requirements for hospitals (NHS and private). They must appoint a responsible person for the unit. The responsible person must publish policies relating to the use of force on the unit, publish information for patients about their rights in relation to the use of force, and ensure that staff members have training and refresher training on the use of force. The policies should be kept under review and relevant people must be consulted with before the policy is published. The training offered should be wide ranging and the Act sets out what it must include, from showing respect for patients’ wishes and feelings and involving patients, to techniques for avoiding or reducing the use of force and the impacts of the use of force.

If force is used the unit must record details of what happened. Again, the Act is prescriptive about what information is needed. Following the use of force, information regarding the force used, the patient, the staff member, the outcome, any injuries suffered, and the efforts to avoid the need for force should be recorded. At the end of each year, the Secretary of State must publish statistics regarding the use of force in mental health units.

Guidance issued under the Act sets out what should happen if a patient dies or is seriously injured in a mental health unit.

Furthermore, The Act also sets out responsibilities for police officers. In circumstances where a mental health unit considers they cannot manage a patient safely without assistance, the police can be called upon to attend. The Act now set out that where police officers attend, they must take a body camera and operate it on the ward ‘where reasonably practicable.’ There is an exception to this where there are ‘special circumstances.’

How could the Act help?

The background to the Act is the devastating death of Olaseni ‘Seni’ Lewis as an in-patient at Bethlem Royal Hospital in Beckenham on 31 August 2010. Seni died as a result of prolonged restraint by police officers. His family and supporters of the Act have worked tirelessly to drive change within our mental health system, a system which should be treating people at their most vulnerable with respect and not endangering them. The Act is therefore to be welcomed on behalf of patients and those providing services, as it should provide care teams with the skills and awareness needed to deal with pressing circumstances.

It is therefore hoped that the Act will reduce the use of force in mental health units. However, we sadly expect there will continue to be cases where force is used inappropriately and disproportionately. The new requirements for policies, record keeping and police body cameras should go some way to reducing the numbers of such cases, and will assist in seeking redress where unlawful practices do continue to occur.

What patients need to know 

• There are policies in place which staff members must follow when using force
• Every patient must be provided with information about their rights
• A record must be kept of force used (unless it is considered negligible)
• Police officers attending mental health units to assist staff members with a patient should wear a body camera
• Patients should seek legal advice if they think unlawful force has been used on a mental health unit

If you have concerns about the way in which you are treated or that of a loved one in a mental health unit, we have specialist lawyers in our public law and human rights team who can advise on this and potential legal challenges. We also have specialists who can advise in relation to autistic people and/or those with a learning disability who are detained in mental health in-patient settings known as Assessment and Treatment Units, so do get in touch if you have concerns or want any advice on these areas.

Read more about our Public Law and Human Rights team.