What are the patient and clinical staff experiences of utilising Mechanical restraint in adult mental health inpatient services? A systematic review

Mechanical restraint (MR) is used in mental health inpatient settings to manage extreme self-harm or aggression, yet its application raises significant ethical and emotional concerns for both patients and staff. Although restrictive practices such as seclusion and physical restraint have been widely examined, research focusing specifically on the experiences surrounding MR remains limited. This review explored perspectives of clinical staff and patients to better understand the impact of MR and to inform safer, more compassionate approaches to its use. A systematic search of qualitative studies across major health databases and grey literature identified seven eligible studies, which were appraised for quality and analysed thematically. Four themes were identified: contrasting perceptions of MR and the meaning attributed to it; staff efforts to prevent or minimise MR through de-escalation; the reliance on structured procedures and clear protocols to guide practice; and the framing of MR as a measure of safety for both patients and staff, influenced by staffing levels and resource availability. Overall, MR emerged as a complex and often distressing intervention. Enhancing training, strengthening guidelines, fostering collaboration with patients, and promoting reflective practice may help reduce harm and support more ethical, person-centred care.