There are specific risks to consider when people with learning disability are physically restrained. David Perry and colleagues outline the safeguards that are recommended if intervention becomes necessary

Using physical interventions to restrict people with learning disabilities has always been a controversial issue. The Department of Health (DH) publication Guidance for Restrictive Physical Interventions (DH 2002), produced as part of the Valuing People White Paper (DH 2001a), acknowledged that such interventions might be appropriate under certain circumstances. Examples include preventing acts of physical violence or severe self-injurious behaviour, while stopping the perpetration of a serious criminal act was another. The guidance emphasised, however, that physical interventions should be used as a last resort and when less aver-sive techniques such as de-escalation had been attempted first.