{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T06:14:12Z","timestamp":1776147252487,"version":"3.50.1"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:00:00Z","timestamp":1776124800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Restrictive interventions, including physical restraint, seclusion, chemical restraint, and segregation, continue to be used within mental health services, despite sustained policy efforts to promote least-restrictive and trauma-informed care. However, little is known about national trends affecting women, for whom restrictive interventions often carry heightened risks of re-traumatisation and stigma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a longitudinal secondary analysis of publicly available administrative data from the Mental Health Bulletin covering NHS-funded mental health services in England between 2017 and 2025. Annual counts of restrictive interventions involving women were examined relative to the number of women detained under the Mental Health Act to estimate annual rates per 1,000 detained. Regression modelling was used to assess temporal trends overall, by age group and type of restrictive intervention, and interrupted time-series analyses to examine changes following implementation of the Mental Health Units (Use of Force) Act 2018 (\u201cSeni\u2019s Law\u201d). Trends were also examined alongside available national data on restrictive interventions involving men.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Rates of restrictive interventions involving women increased by approximately 12 percent per year over the study period, with no evidence of a reduction following the introduction of Seni\u2019s Law. Increases were most pronounced for chemical restraint, seclusion, and segregation, while physical and mechanical restraint remained stable. Restrictive interventions declined among women under 18 but increased consistently across all adult age groups, indicating a widening age-related divergence. Although overall trends broadly mirrored those observed among men, the types of restrictive interventions used and their potential impact may differ, highlighting gendered dimensions in how restrictive practices are experienced and applied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Despite extensive national initiatives, restrictive interventions involving women have continued to rise in England, highlighting a persistent gap between policy intent and practice. The findings suggest that legislative frameworks alone are insufficient to achieve meaningful reductions without operational changes in clinical practice, organisational culture, and monitoring systems. Internationally, the study contributes rare gender-disaggregated longitudinal evidence and highlights the need for comparable monitoring systems and coordinated research to inform rights-based, trauma-informed strategies to reduce restrictive interventions in mental health services.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyt.2026.1787826","type":"journal-article","created":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T05:39:34Z","timestamp":1776145174000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A longitudinal analysis of the prevalence of restrictive interventions involving women with mental health conditions, learning disabilities or autism in mental health services in England"],"prefix":"10.3389","volume":"17","author":[{"given":"Kathryn","family":"Fradley","sequence":"first","affiliation":[{"name":"School of Nursing and Public Health, Faculty of Health and Education, Manchester Metropolitan University","place":["Manchester, England, United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alina","family":"Haines-Delmont","sequence":"additional","affiliation":[{"name":"School of Nursing and Public Health, Faculty of Health and Education, Manchester Metropolitan University","place":["Manchester, England, United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.17041","article-title":"Prevalence and variability of restrictive care practice use (physical restraint, seclusion and chemical restraint) in adult mental health inpatient settings: A systematic review and meta\u2010analysis","volume":"33","author":"Belayneh","year":"2024","journal-title":"J Clin Nurs"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1192\/bjo.2022.571","article-title":"A systematic review of in-patient psychiatric care for people with intellectual disabilities and\/or autism: effectiveness, patient safety and experience","volume":"8","author":"Melvin","year":"2022","journal-title":"BJPsych Open"},{"key":"B3","doi-asserted-by":"crossref","DOI":"10.1007\/978-3-319-26748-7_9","article-title":"The uses of coercive measures in forensic psychiatry: A literature review","volume-title":"The use of coercive measures in forensic psychiatric care: Legal, ethical and practical challenges","author":"Hui","year":"2016"},{"key":"B4","volume-title":"Restrictive practices in restrictive places: Factors associated with, and interventions to reduce restrictive practices in secure mental health settings","author":"Lawrence","year":"2025"},{"key":"B5","volume-title":"Positive and Proactive Care: reducing the need for restrictive interventions","author":"Department of Health","year":"2014"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1111\/inm.12966","article-title":"Women\u2019s experiences of restrictive interventions within inpatient mental health services: A qualitative investigation","volume":"31","author":"Scholes","year":"2022","journal-title":"Int J Ment Health Nurs"},{"key":"B7","doi-asserted-by":"publisher","first-page":"140\u2013173","DOI":"10.47760\/cognizance.2023.v03i10.011","article-title":"Women\u2019s experiences of restrictive interventions in inpatient units and how they impact their recovery","volume":"7","author":"Eben","year":"2023"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1111\/1467-8462.12446","article-title":"Patients\u2019 and staff members\u2019 experiences of restrictive practices in acute mental health in-patient settings: systematic review and thematic synthesis","volume":"8","author":"Butterworth","year":"2022","journal-title":"BJPsych Open"},{"key":"B9","volume-title":"The Women\u2019s Mental Health Taskforce: Final Report","author":"Department of Health and Social Care","year":"2018"},{"key":"B10","volume-title":"Reducing restrictive practice through least coercive care (Mental Health, Learning Disability and Autism Inpatient Quality Transformation Programme)","year":"2025"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0319228","article-title":"Factors involving in healthcare professionals\u2019 decision-making process regarding the use of restrictive care practices in adult mental health inpatient units: A protocol for an umbrella review","volume":"20","author":"Belayneh","year":"2025","journal-title":"PLoS One"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1192\/bjo.2023.613","article-title":"Comparison of coercive practices in worldwide mental healthcare: overcoming difficulties resulting from variations in monitoring strategies","volume":"10","author":"Savage","year":"2024","journal-title":"BJPsych Open"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.3109\/13668250.2019.1639895","article-title":"Factors associated with long-term use of restrictive interventions","volume":"45","author":"Richardson","year":"2020","journal-title":"J Intellectual Dev Disability"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.3109\/09540261.2010.512283","article-title":"Domestic violence and mental health","volume":"22","author":"Howard","year":"2010","journal-title":"Int Rev Psychiatry"},{"key":"B15","first-page":"3","article-title":"Convention on the Rights of Persons with Disabilities.","volume-title":"Treaty Series","year":"2006"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1111\/inm.12451","article-title":"Fear and blame in mental health nurses\u2019 accounts of restrictive practices: Implications for the elimination of seclusion and restraint","volume":"27","author":"Muir\u2010Cochrane","year":"2018","journal-title":"Int J Ment Health Nurs"},{"key":"B17","volume-title":"How CQC identifies and responds to closed cultures","author":"Care Quality Commission","year":"2022"},{"key":"B18","volume-title":"Mental health units (Use of force) act (Seni\u2019s law)","year":"2018"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1007\/s11293-018-9587-5","article-title":"Childhood bullying and labor market outcomes in the United States","volume":"46","author":"Mukerjee","year":"2018","journal-title":"Atlantic Economic J"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17165887","article-title":"Effects of data aggregation on time series analysis of seasonal infections","volume":"17","author":"Alarcon Falconi","year":"2020","journal-title":"Int J Environ Res Public Health"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1","DOI":"10.7758\/rsf.2019.5.2.01","article-title":"Using administrative data for social science and policy","volume":"5","author":"Penner","year":"2019","journal-title":"RSF: Russell SAGE Foundation J Soc Sci"},{"key":"B22","article-title":"Using aggregate administrative data in social policy research","author":"Jacob","year":"2016"},{"key":"B23","volume-title":"RStudio: Integrated development environment for R","year":"2023"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.3389\/fdgth.2022.945635","article-title":"PROD-ALERT: Psychiatric restraint open data\u2014analysis using logarithmic estimates on reporting trends","volume":"4","author":"Reid","year":"2022","journal-title":"Front Digital Health"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1111\/jpm.12532","article-title":"Catching your tail and firefighting\u201d: The impact of staffing levels on restraint minimization efforts","volume":"26","author":"McKeown","year":"2019","journal-title":"J Psychiatr Ment Health Nurs"},{"key":"B26","article-title":"Children and young people\u2019s mental health services: transformation and improvement priorities","year":"2019"},{"key":"B27","volume-title":"Quality Network for Community CAMHS: Standards and Guidance","year":"2018"},{"key":"B28","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1192\/bjb.2025.10","article-title":"Reporting of oral chemical restraint in the Mental Health Services Monthly Statistics for England","volume":"50","author":"Cranshaw","year":"2025","journal-title":"BJPsych Bull"}],"container-title":["Frontiers in Psychiatry"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2026.1787826\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T05:39:38Z","timestamp":1776145178000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2026.1787826\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,14]]},"references-count":28,"alternative-id":["10.3389\/fpsyt.2026.1787826"],"URL":"https:\/\/doi.org\/10.3389\/fpsyt.2026.1787826","relation":{},"ISSN":["1664-0640"],"issn-type":[{"value":"1664-0640","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,14]]},"article-number":"1787826"}}