Rates of restrictive practices in acute adult inpatient psychiatry units in Ireland

This paper examines rates of physical restraint and seclusion under the Mental Health Act 2001 in acute adult psychiatry inpatient facilities ("approved centres") in Ireland. Analysis of rates of physical restraint and seclusion in acute adult approved centres in Ireland in 2023, based on data made publicly available by the Mental Health Commission, Health Research Board, and Central Statistics Office. Rates of physical restraint vary 16-fold between approved centres, ranging from 116 episodes of physical restraint per 100,000 population per year to 7 per 100,000 population, with a national rate of 39 per 100,000 population. Among the six approved centres with the highest rates of physical restraint, five are in Dublin (i.e. urban). Among approved centres that use seclusion, rates vary 19-fold, ranging from 38 episodes of seclusion per 100,000 population to 2 per 100,000 population, with a national rate of 15 per 100,000 population. There are within-country variations in rates of physical restraint and seclusion in Ireland, but these are of a lesser magnitude than between-country variations. Overall, Ireland's rates of restrictive practices are lower than those in other jurisdictions, consistent with Ireland's low rate of involuntary admission. Future research could usefully focus on the relationship between restrictive practices and urbanicity, among other themes.