Restrictive interventions, which include enhanced observations, seclusion and restraint, are associated with significant and far-reaching harm for patients, staff and those who witness their use. They should only ever be used as the last resort. However, mental health professionals often encounter patient behaviours that challenge, which can include violence, which may prompt them to use restrictive interventions. The primary prevention of patient behaviours that challenge is crucial to reduce the need for restrictive interventions in mental health settings.

This article discusses the different types of restrictive interventions and describes some strategies that can support reduction of their use in mental health settings. The authors also consider some of the legal and ethical aspects of restrictive interventions and identify the importance of adopting a trauma-informed approach to care.