Systemic trauma of restraint in mental health care: How colonial-era coercion persists and what reparative care requires
Original framing: “Restraint can leave mental health patients traumatised. New research reveals what they need afterwards” — The Conversation - Global
The **Mad Movement’s** **‘Nothing About Us Without Us’** principle is violated by this research, which centers **clinicians’ perspectives** over those directly harmed. **Judy Chamberlain (UK Mad activist)** has documented how restraint survivors are **gaslit into silence** by ‘trauma-informed care’ that still pathologizes their experiences. In **South Africa**, the **Treatment Action Campaign’s** mental health wing reports that **Xhosa patients** describe restraint as **‘being buried alive’**, yet these testimonies are absent. The research’s **‘patient-centered’** language masks how **disability justice** frameworks—like those of **Patty Berne (Sins Invalid)**—demand **abolition**, not reform. **Queer and trans patients** face **higher restraint rates** due to **gendered violence** in psychiatric wards, a reality erased here.
The research’s framing of restraint as a **technical failure of ‘support’** obscures its role as a **racialized, colonial, and carceral practice** embedded in psychiatry’s history.
While it highlights **neuroscientific trauma responses**, it ignores how **systemic racism, Indigenous resistance, and global South alternatives** offer **viable pathways** beyond coercion. The **trickster lens** reveals restraint as a **deceptive ‘solution’**, much like **Anansi’s web**, trapping patients in cycles of **‘trust-building’** that never question the **power structures** enabling harm. **Decolonial and Mad-led models**—from **Brazil’s CAPS centers** to **Māori whānau ora**—prove that **restraint-free systems are possible**, but require **funding shifts, governance reforms, and centering marginalized voices**. The **future-modelling dimension** warns that without these changes, restraint will **escalate globally**, yet the **solution pathways** demonstrate that **abolition is achievable** when rooted in **justice, not incrementalism**. The **missing historical and Indigenous dimensions** show that restraint is not a **neutral tool** but a **legacy of oppression**, and its persistence is a **failure of imagination**, not a lack of alternatives.