Physical interventions for people with intellectual disabilities: staff training and policy frameworks

Background: Physical intervention or restraint with people who have intellectual disabilities is sometimes necessary, even though it is known to present dangers to both staff and service users (some service users have died as a result of restraint). Aims: This study aims to investigate the extent to which staff in intellectual disability services were trained in the use of physical interventions or restraint. Their views of a recent policy framework on physical interventions were also sought. Methods: There were three groups of participants: (i) group 1 included staff who had attended conferences on the Policy Framework (the conference sample); (ii) group 2 included staff from two geographical areas (the geographical sample); (iii) group 3 included staff in specialist assessment and treatment services (the SpAT sample). All participants were sent a questionnaire asking them about their training in (and use of) physical intervention methods and their opinions on the policy document. Results: There were at least 12 different types of training recorded, including a number of varieties of Control and Restraint (C&R). By no means did all the senior staff did have training in physical intervention methods. The degree of training varied with the sample and the type of training varied with the employing organization. Most participants in group 1 were very positive about the BILD & NAS Policy Framework but few staff in groups 2 and 3 had read the document. About two-thirds of the participants said their services had (or were developing) a written policy on physical interventions. Conclusions: There remained a clear need for further training in physical interventions and evidence on which the effectiveness of different methods of physical interventions could be judged.