Least restrictive practice: its role in patient independence and recovery

One of the five overarching principles of the Mental Health Act: Code of Practice is to provide patients with care and treatment which is least restrictive whilst encouraging recovery and promoting independence. However, there is limited research which explores the application of these principles within a medium secure unit. The aims of the research were to explore what are patient’s experiences of least restrictive practices and to what extent do they perceive that least restrictive practices maximise their independence and recovery. Semi-structured interviews were carried out with 12 male inpatients within a medium secure unit. Five themes were evident: Positive Changes, Perceived Lack of Transparency, Social Isolation, Institutionalisation and Normality. It was found that patient’s perceived that there was lack of shared understanding between staff and patients of what is considered least restrictive. Patient recovery was promoted through positive risk-taking, the reduction in the use of seclusion and through the promotion of meaningful activities that resembled life in the community. Nevertheless, patients perceived that there was a lack of opportunities to socialise with patients from other wards. Due to the security level of the hospital patients perceived that independence was not achievable.