There is a need to reduce the harm experienced individuals who are receiving care within mental health services.

Service Description

The Mental Health Programme seeks to reduce the harm experienced by individuals who are receiving care within mental health services. To meet this aim, the programme supports frontline staff to test and gather real-time data and reliably implement interventions. Through collaboration and innovation from staff, service users and carers and the use of quality improvement science over the last three years, we are now starting to see significant reductions in self harm, seclusion, violence and aggression, and restraint across a number of areas in Scotland.


The programme works with all NHS boards with a focus on inpatient acute admission, rehabilitation, Intensive Psychiatric Care Units and Forensic Units. Planning is underway to look at a wider range of mental health services.


NHS boards

Benefits of programme

There are a number of references in NHS Boards to suggest the use of the programme is supporting cultural and attitude changes. How restraint is viewed and how challenging behaviour is managed is beginning to change. There are examples where restraint isn’t seen as a ‘first line’ response to challenging situations. Instead, there is an examination of practice with questions asked such as: can this be avoided? what factors are contributing to this that can be mitigated? can the environment be adapted and is there appropriate activity?

Data gathered from individual wards show a number of areas across NHSScotland are making real improvements, including:

  • a reduction of up to 63% in the rate of restraint
  • reductions in the percentage of patients who self-harm of up to 57%, and
  • a reduction of up to 54% in rates of violence.


Johnathan Maclennan


Tool Kit