What this is
The Independent Review of the Mental Health Act 1983, commissioned by the government and chaired by Professor Sir Simon Wessely. It reported on 6 December 2018 as Modernising the Mental Health Act: increasing choice, reducing compulsion, a document of 322 pages [1].
It examined rising rates of detention under the Act, the disproportionate number of people from black and minority ethnic groups detained under it, and processes judged out of step with a modern mental health care system. Its terms were reform of the law, not inspection of any service.
What it records
On restraint, the review found that data collection was inconsistent, but that restraint “continues to be a routine occurrence on many wards” [2].
It recorded that restraint falls disproportionately on people from ethnic minority communities, and on women and girls. It recorded that pain-based and prone restraint is particularly traumatising and can be life threatening.
It found practice defended as necessary that was not the least restrictive option available: blanket restrictions applied to everyone on a ward, and restrictions that were never written down or justified to anyone.
How to read it
The finding on data is the one to carry into a ward. Where collection is inconsistent, a service cannot say how often it restrains anyone. The people most often restrained, by ethnicity, by sex, by diagnosis, disappear from the numbers first. A low count is then not evidence of low restraint. It is evidence that nobody counted.
The review could still say restraint was routine, and still say who carried it, because service users and their accounts supplied what the returns did not. That is the second reading rule: patient experience is a data source, not a colour supplement to the figures.
This is a review, so it recommends. It makes no finding against any service or any person, and it measures nothing in any named ward.
Where it stops
Published in December 2018, describing practice before that. It is evidence about the Mental Health Act system of the 2010s, not about a ward today [1].
It covers England. It reviews legislation and its use rather than inspecting services, and it prints no single national count of restraint.
The report does not print a numbered total of its recommendations in the text read for this page, so no count is given here. The government accepted the case for reform, and the recommendations fed the subsequent draft Mental Health Bill. What became of each recommendation sits outside this document.
Confidence: confirmed. The publication page and the full report PDF were both opened, and the restraint and coercion passages quoted here are from the report.
Sources
[1] Department of Health and Social Care, Modernising the Mental Health Act, final report of the independent review, 6 December 2018 · https://www.gov.uk/government/publications/modernising-the-mental-health-act-final-report-from-the-independent-review
[2] Independent Review of the Mental Health Act, Modernising the Mental Health Act: increasing choice, reducing compulsion, full report, 322 pages, December 2018 · https://assets.publishing.service.gov.uk/media/5c6596a7ed915d045f37798c/Modernising_the_Mental_Health_Act_-_increasing_choice__reducing_compulsion.pdf
Where a ward is reviewing a restraint after the event, our physical interventions training covers prone and pain-based restraint, the risk that continues after the hold, and what has to be recorded.
Reviewed 20 October 2026.