Longitudinal Trends in Restrictive Interventions Among Women in England's Mental Health Services

Overview

This longitudinal study analyzed national data from 2017 to 2025 on restrictive interventions involving women detained under the Mental Health Act in England. Findings reveal a 12% annual increase in restrictive interventions among women, particularly chemical restraint, seclusion, and segregation, with no reduction following Seni’s Law implementation.

Background

Restrictive interventions such as physical restraint, seclusion, chemical restraint, and segregation are commonly used in mental health services but carry significant risks of trauma, especially for women. Despite policy efforts in England to minimize these practices, quantitative evidence on trends among women remains limited. Women with mental health disorders, learning disabilities, or autism are particularly vulnerable to these interventions, which may exacerbate gendered health inequalities and violate human rights principles. This study provides the first national longitudinal analysis focusing on women, examining trends by age and intervention type alongside legislative impacts.

Data Highlights

Key Findings

• Restrictive interventions involving women increased by approximately 12% annually from 2017 to 2025.
• No evidence of reduction in restrictive interventions following the Mental Health Units (Use of Force) Act 2018 (Seni’s Law).
• Increases were most pronounced in chemical restraint, seclusion, and segregation; physical and mechanical restraint rates remained stable.
• Restrictive interventions decreased among women under 18 but increased consistently across all adult age groups, indicating widening age-related disparities.
• Overall trends in women broadly mirrored those in men, but types and impacts of interventions differed, highlighting gendered dimensions.

Clinical Implications

The persistent rise in restrictive interventions among women despite legislative efforts underscores the need for operational and cultural changes within mental health services. Clinicians should prioritize trauma-informed, gender-sensitive approaches and advocate for enhanced monitoring and accountability systems. Tailored strategies are essential to address the distinct risks and experiences of women, particularly adults, to reduce reliance on restrictive practices.

Conclusion

Restrictive interventions involving women in England’s mental health services have increased over recent years, with legislative measures alone insufficient to curb this trend. Comprehensive, gender-sensitive operational reforms are critical to align practice with policy goals and human rights standards.

References

1. Mental Health Bulletin 2017-2025 -- National Data on Restrictive Interventions
2. Mental Health Units (Use of Force) Act 2018 (Seni’s Law)
3. UK Policy Frameworks on Restrictive Interventions and Women’s Mental Health