Mechanical Restraint in Psychiatric Hospitals Linked to Double the Risk of Dangerous Blood Clots, Study Finds

New research published in the BMJ finds that patients physically restrained in psychiatric settings face around twice the risk of venous thromboembolism within 30 days compared with those given medication to manage behaviour.

When Restraint Becomes a Health Risk

Picture a psychiatric ward during a crisis moment — staff making split-second decisions about how to keep a patient and those around them safe. Those decisions, it turns out, may carry consequences that stretch well beyond the immediate incident. New research shared by the BMJ suggests that the *type* of restraint used matters more than many might have assumed.

The study, flagged by the BMJ’s official account, found that mechanical restraint — physical methods such as straps or belts used to restrict a patient’s movement — was associated with a twofold higher risk of venous thromboembolism in the 30 days following restraint, when compared with chemical restraint, which involves the use of sedative or calming medication.

Venous thromboembolism, or VTE, is a condition where blood clots form in the veins. It covers two related problems: deep vein thrombosis, where a clot develops in a deep vein — usually in the leg — and pulmonary embolism, where that clot travels to the lungs. Both can be life-threatening if not caught and treated quickly.

What the Numbers Actually Show

The absolute risk remains low. That’s an important distinction. A twofold increase sounds alarming, but when the baseline risk is small, the real-world numbers stay modest. Still, the researchers argue that even a low absolute risk warrants heightened prevention efforts — above all because patients in psychiatric settings are already a vulnerable group, often with complex physical health needs that can go unaddressed.

Blood clots can develop when someone is immobilised for a period of time. Mechanical restraint, by its very nature, restricts movement — and that reduced mobility may be a factor in the association the researchers identified.

The Bigger Picture for Psychiatric Care

This isn’t simply a statistical curiosity. Restraint practices in mental health settings have long been the subject of scrutiny from patient safety campaigners, NHS regulators, and mental health charities. NHS England has previously set out ambitions to reduce the use of restrictive practices across inpatient mental health services, with a focus on trauma-informed care and de-escalation techniques.

The findings add a specific, physical health dimension to that conversation. It’s one thing to debate the ethics and dignity of restraint. It’s another to point to a measurable clinical risk that follows from it.

According to the BMJ’s reporting of the findings, the results support heightened prevention efforts — meaning clinical teams may need to think more carefully about blood clot prevention protocols for patients who have been mechanically restrained, in the same way that VTE prevention is standard practice after surgery or prolonged bed rest.

What Happens in Kent’s Mental Health Services

NHS Kent and Medway Integrated Care Board oversees mental health provision across the county, with services delivered through Kent and Medway NHS and Social Care Partnership Trust. Like all NHS mental health trusts in England, they operate under national guidance on restrictive practices and patient safety. The trust has not commented specifically on this research.

Mental health inpatients in Kent, as elsewhere, are subject to the same national frameworks around restraint — and the same questions this study raises will apply to clinical teams working in wards across Maidstone, Canterbury, Medway, and beyond.

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Key Takeaways

• Mechanical restraint in psychiatric hospitals was associated with a twofold higher risk of venous thromboembolism within 30 days, compared with chemical restraint, according to research published by the BMJ
• The absolute risk of blood clots remains low — but researchers say the findings support stronger prevention measures for patients who have been physically restrained
• Venous thromboembolism covers both deep vein thrombosis and pulmonary embolism, both of which can be serious or fatal if untreated

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What This Means for Kent Residents

If you or a family member receives care in a mental health inpatient setting in Kent, it’s worth knowing that national NHS guidance already includes VTE prevention as part of routine patient safety checks — and this research may prompt clinical teams to review those protocols further. If you have concerns about the care of someone in a psychiatric ward, you can speak to the ward’s patient advice and liaison service, known as PALS, or contact NHS 111 for general health guidance. For anyone experiencing a mental health crisis, the Samaritans are available around the clock on 116 123, and in a medical emergency — including symptoms of a blood clot such as sudden leg pain, swelling, or difficulty breathing — always call 999.