The use of restrictive practices in Irish mental health centres has decreased by almost 50% in the past five years, according to a report by the Mental Health Commission (MHC).
Restrictive practices include physical restraint, seclusion or mechanical restraint.
In the ten years between 2008 to 2018, instances of physical restraint had increased year on year.
Now that trend has been reversed, with a reduction in episodes of physical restraint over the past five years, and the use of overall restrictive practices dropping by almost half from 6,747 in 2019 to 3,467 individual interventions last year.
Meanwhile, there has been a dramatic shift downwards in seclusion in recent years - with the number of episodes dropping from 1,364 in 2022 to 895 in 2023.
In terms of mechanical restraint, 2023 data indicates that the use continues to be rare.
Two centres reported the use of mechanical restraint last year.
However, the commission is hopeful it can be further reduced and, where possible, eliminated in future years.
The commission maintains the above reductions are reflective of changing societal attitudes to restrictive practices and the progressive steps are in keeping with Irish commitments to international human rights.
The MHC believes the continuing fall in the use of restrictive practices can be traced to the effect of robust regulation and motivated mental health services - and staff - who continue to promote a human rights-based approach to inpatient services for people using services.
Revised rules and codes - which came into effect on 1 January 2023 - occurred because of international developments around human rights, the advancement of person-centred care, and evidence demonstrating that restrictive practices can have harmful physical and psychological consequences.
Outgoing Minister for Mental Health and Older People Mary Butler said she welcomed the findings of the report.
"It is encouraging to see that there has been a downward trend over the last number of years in the use of restrictive practices, in line with the Mental Health Commission's Reduction Strategy. I am particularly heartened that a human-rights approach is being embraced and adopted by staff in mental health services.
"This report reflects our more person-centred and human rights focused approach to mental health," Ms Butler added.
John Hillery who is the Chairperson of the Mental Health Commission said: "The continuing fall in the use of restrictive practices shows the symbiotic effect of robust regulation and motivated mental health service staff in promoting the evolution of human rights-based inpatient services for vulnerable patients in Ireland."
Chief Executive of the Mental Health Commission John Farrelly said the report highlights clearly the change in approach,
"From 2008 to 2018, episodes of physical restraint and the number of residents that were being physically restrained increased year-on-year," he said.
"It is clear from our work with them that this generation of clinicians are determined to ensure that everyone has a therapeutic encounter if or when they enter our mental health services, and that the use of coercion is not part of that culture," Mr Farrelly added.
Speaking on RTÉ's Morning Ireland, he said people want a "therapeutic environment" and a new system was brought in based on a review of practices.
"The training is much more than just about physical restraint. Training also includes human rights. And it also includes other ways of interacting therapeutically with someone, with somebody.
"Nobody likes any restrictive practices, particularly in terms of trauma informed care, neither staff nor patients, and we're on the road to elimination, but I wouldn't stand over any restrictive practices."
