Coroners, courts, regulators and inspectors have recorded what restraint does to the people it is used on. This casebook publishes those records as short, sourced case pages: what happened, what went wrong, and what it means for the people running the service.

Every entry states its confidence, what could not be verified, and where the source runs out. Where a case is still live, we hold it. Where a name cannot be justified, we do not print it. Publications are labelled as publications, because a national count is not an incident.

147 case entries and 47 publications.

A neck hold in the street, and a man dead in the back of a van

A 34-year-old asylum seeker was held in a headlock during an arrest and died of asphyxia from compression of the neck; an inquest jury found him unlawfully killed.

Police custody · 1990s

A prone restraint in the street, and a verdict the High Court quashed

A man detained under the Mental Health Act died after being restrained face down, and the unlawful-killing verdict a jury reached did not survive.

Police custody · 1990s

Arrested after an argument with her mother, and dead in custody

A 49-year-old teaching assistant was arrested for an alleged breach of the peace, restrained, and died of a cardiac arrest in police custody.

Police custody · 2000s

Eleven minutes on a custody floor, and nobody touched him

A former paratrooper was dragged into a police station face down, handcuffed and left there, and an inquest jury found he had been unlawfully killed.

Police custody · 1990s

Eleven officers held him in a police van, and he died in it

A man detained under the Mental Health Act died on the way to a psychiatric hospital while eleven officers restrained him in the back of a van.

Police custody · 1980s

Fifteen minutes face down on the ground, and a man who said he could not breathe

A father of seven was held face down by three officers after an arrest for being drunk and disorderly, and died of postural asphyxia.

Police custody · 1990s

He went limp twice, and then they sprayed him

A man in acute mental illness was restrained face down at a police station and CS-sprayed while handcuffed; an inquest jury found he was unlawfully killed.

Police custody · 1990s

Held on the ground for a few minutes, and no charges

A man died after four officers restrained him prone in a London street, and the Crown Prosecution Service decided a brief restraint was not unlawful.

Police custody · 2000s

On his side when loaded, on his front when he arrived

A 38-year-old man died of positional asphyxia after police restrained him, handcuffed him and drove him to the station on the floor of a van.

Police custody · 2000s

Pinned face down outside his home, while his face turned blue

A 29-year-old man was handcuffed and held face down by officers while a witness saw his face change colour.

Police custody · 2000s

Dying on the ground, read as feigning unconsciousness

A 39-year-old father of three suffered a cardiac arrest while several officers restrained him face down at a stop and search.

Police custody · 2000s

Eight minutes face down, then read as faking

Held face down for seven to eight minutes, then treated at Brixton as if he were faking.

Police custody · 2000s
Publication

Eighty-six deaths after restraint, sixteen counted as restraint deaths

In 2012 a BBC and Bureau of Investigative Journalism investigation put the number of people who died in police custody after restraint at 86 over eleven years, of…

Police custody · 2010s

Eleven hours in handcuffs at thirty weeks pregnant

A pregnant woman was handcuffed behind her back for eleven hours in a police cell, and the force later accepted the restraint had never been reviewed.

Police custody · 2010s

Face down in the street for thirteen minutes

A father of two detained under section 136 was held prone in the street, then left unconscious and unobserved in a police cell.

Police custody · 2010s

Fifty-five minutes of restraint, ending face down on the floor

A detained patient restrained twice in one day died after a hold that ended face down, and the jury found excessive restraint caused his death.

NHS mental health · 2000s

Handcuffed and leg-restrained at a swimming pool

A severely autistic 16-year-old on a school trip jumped into a pool and was handcuffed and leg-restrained by police who pulled him out.

Police custody · 2000s

He said he could not breathe thirteen times

A man in acute behavioural disturbance was restrained by about six officers and died within hours. The inquest found a serious failure to recognise it as a medical…

Police custody · 2010s

Held down and injected with three times the recommended dose

An inpatient at Broadmoor was held down and injected with 150mg of promazine, and died within minutes.

NHS mental health · 1990s

Held face down on a secure unit floor for at least twenty-five minutes

A detained patient was held prone for at least 25 minutes, collapsed during the restraint, and was pronounced dead after midnight.

NHS mental health · 1990s

Seven officers, a prone hold and a belt round his face

An emergency belt authorised as spit protection was wrapped round a restrained man's face, and he died seven days later.

Police custody · 2010s

Six officers, one man face down on a street

A 31-year-old father of two was restrained prone on a residential street by six police officers and died in custody. No officer was charged, and the public inquiry…

Police custody · 2010s
Publication

The inquiry that found a seclusion room with no records

The Fallon inquiry into Ashworth's personality disorder unit reported in 1999 that a seclusion room was filthy and that no seclusion records were being kept, in a high-security…

NHS mental health · 1990s
Publication

The inquiry told to accept every recommendation but one

In 1992 a committee of inquiry into Ashworth Special Hospital made 90 recommendations. The Secretary of State accepted all of them except the one that would have ended…

NHS mental health · 1990s

A child came home from school with his lips blue

An 11-year-old autistic pupil was held face down by four adults at his special school, and the diary said nothing.

School · 2010s

Held face down by eleven officers in a hospital seclusion room

A 23-year-old man with no psychiatric history died after police held him face down, and nobody gave basic life support when he collapsed.

NHS mental health · 2010s

Held in the same position that had already caused breathing problems

A long-term patient died after breathing difficulties during restraint, months after the same position had caused the same problem.

NHS mental health · 2000s

Restrained, sedated, and found collapsed in seclusion

A 24-year-old detained patient died after a restraint the inquest jury called inappropriate at times, during which a member of staff knelt on his back.

NHS mental health · 2000s

Sedated and secluded, with observation found inadequate

An inquest found that observation of a woman sedated and held in seclusion at a Milton Keynes mental health unit was inadequate in the hours before she died.

NHS mental health · 2010s

Sixteen minutes on the floor before he stopped responding

He was restrained on his side, the position trainers teach, and became unresponsive anyway; the failures the regulator found were in the cell checks that followed.

Police custody · 2010s

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