What this is
An Act of Parliament, the Mental Health Units (Use of Force) Act 2018, chapter 27, which received Royal Assent on 1 November 2018. It defines restraint in law for mental health units in England.
Use of force means physical, mechanical or chemical restraint on a patient, or isolation. Physical restraint is contact intended to prevent, restrict or subdue movement of any part of the body. Mechanical restraint is a device used for that purpose, and chemical restraint is medication used for it. Isolation means any seclusion or segregation imposed on a patient.
What it records
The duties sit with the provider of each unit. Section 2 requires a “responsible person” of appropriate seniority, accountable for the Act’s requirements. Section 3 requires a published policy setting out the steps being taken to reduce the use of force. Section 4 requires information for patients about their rights. Section 5 requires staff training on avoiding or reducing force, its risks and impacts, patients’ wishes and feelings, diversity and discrimination, and the principal legal and ethical issues, with refresher training. Section 6 requires a record of any use of force, with demographic detail across protected characteristics, kept for three years. Section 7 requires annual national statistics.
Who it binds matters as much as what it says. It applies in England, to detained and informal patients, in NHS hospitals and in independent hospitals providing NHS-funded care. The statutory guidance issued with it is addressed to NHS organisations in England and to police forces in England and Wales. Enforcement runs through NHS commissioning and Care Quality Commission inspection, not a single regulator decision.
How to read it
The duties form a chain of linked obligations, and the inquests in this casebook keep finding the same three missing: the record, the training, the review.
The guidance says it plainly. Use of force had “for too long been accepted as the norm in many mental health services”. Services managed behaviour rather than preventing escalation, and recording, training and investigation were inconsistent nationally. The guidance adds that use of force is at an all-time high, and is used disproportionately against Black and ethnic minority groups, women and girls, autistic people and people with a learning disability.
Part of the rise is the Act itself: it requires data practice had not been keeping, so a rising count is not automatically worse practice.
Where it stops
England, mental health units, patients. It says nothing about schools, care homes, police custody, prisons, immigration detention, Scotland, Wales or Northern Ireland.
The provisions summarised here are duties of policy, information, training, recording and statistics. They do not set a test for when force may lawfully be used, and nothing in them creates a criminal offence.
Two limits. The sections are summarised from the casebook record rather than quoted, and the guidance held is the 2021 consultation draft, not the final version, so check any wording before quoting it.
Sources
- Mental Health Units (Use of Force) Act 2018 (c.27), as enacted, 1 November 2018 · https://www.legislation.gov.uk/ukpga/2018/27/enacted
- Department of Health and Social Care, Mental Health Units (Use of Force) Act 2018: statutory guidance for NHS organisations in England and police forces in England and Wales, draft for consultation, 2021 · https://www.gov.uk/government/consultations/mental-health-units-use-of-force-act-2018-statutory-guidance
Where staff are working with people in crisis who may need physical intervention, our training on vulnerable and volatile persons covers the definitions, the record and the review the Act requires.
Reviewed 20 October 2026.