Compassionate conversations after restrictive interventions can help mental health patients feel heard and regain a sense of control. David Pereiras/ShutterstockMost of us know what it feels like to be ill and frightened. Now imagine being held down by the very people responsible for your care.This can happen in mental health hospitals when staff believe someone poses a risk to themselves or others. Patients may be physically restrained, locked in a room alone or given medication to calm them quickly. These measures are known as restrictive interventions. Although they are intended to prevent harm, they can cause serious injuries and, in extreme cases, death.Our research suggests that what happens after a restrictive intervention can affect how people recover from the experience. The support they receive may help them feel safe again, while a lack of support can add to their distress.Concerns about the use of force in mental health care go back almost 200 years. In 1839, psychiatrist John Conolly introduced a policy at Hanwell Asylum in Middlesex that ended the use of mechanical restraints such as straitjackets and handcuffs. However, historical research shows that Conolly continued to advocate locking patients in rooms alone, a practice known as seclusion.Today, restrictive interventions remain part of mental health care. Research has shown that these experiences can be deeply distressing and sometimes traumatic, even when staff consider them necessary to prevent harm. Read more: Restraint in mental health hospitals: what families want staff to understand Some patients experience nightmares, intrusive memories or symptoms of post-traumatic stress disorder (PTSD) long after the intervention has ended. A review of patients’ experiences of mental health hospitals also found that fear of restraint could discourage people from seeking help.Yet much less attention has been paid to what hospitals can do to support people afterwards.A 2022 review of 21 studies found that patients frequently reported feeling frightened, powerless and unheard during restrictive interventions. Many also described poor communication from staff afterwards, leaving them with unanswered questions about what had happened. Some felt that once the immediate incident was over, it was forgotten by the staff involved. For the patient, however, the experience could remain distressing for months or even years.We wanted to understand how mental health services could respond more effectively.In our research, we examined 35 research publications and policies obtained from 46 NHS mental health trusts in England. We also worked with patients, carers and mental health staff to understand what people need following restrictive interventions.Although NHS guidance recommends that patients receive support and have opportunities to discuss incidents, a separate analysis of hospital policies found considerable variation in how that support was described and organised.Support needs to continue beyond the incidentOne important finding was that talking about what happened can be valuable, but the timing and approach are crucial.Immediately after being restrained, someone may still be frightened, angry or overwhelmed. They may need reassurance, practical help or simply some time and space before they feel ready to discuss the experience.Being offered a conversation at that moment may feel like another demand rather than an opportunity for support.But if a patient declines to talk immediately, they may receive no further opportunity. Our research suggests that declining a conversation should not mean losing access to support altogether.Instead, support should continue, with opportunities to discuss what happened when the person feels ready.When patients do want to talk, their needs may differ. Some want to describe how the experience affected them, while others want to understand why staff acted as they did. They may also want to explain what could have been handled differently.Whatever the conversation involves, patients want to feel listened to, understood and taken seriously. Having some choice over when and where the conversation happens, and who takes part, can help restore a sense of control after an experience in which they may have felt powerless.Our research also found that people wanted to know their concerns had made a difference. This could mean changes to their individual care plan or improvements in how the hospital responds to similar situations.Without any visible response, conversations risk becoming a box-ticking exercise that leaves patients feeling dismissed.Providing this kind of support also depends on the wider hospital environment. Staff need the time and support to listen to patients, reflect on what happened and act on what they learn.A frightening experience cannot be undone. But being ignored or dismissed afterwards can deepen the harm, while compassionate support may help patients begin to rebuild their trust in the people caring for them.The findings offer a lesson that extends beyond mental health hospitals. When someone has experienced something frightening, the way others respond afterwards can become an important part of their recovery.Nutmeg Hallett receives funding from the National Institute for Health and Care Research. Nutmeg Hallett is a member of the Green Party.John Baker receives funding from the National Institute for Health and Care Research (NIHR). He is currently a NIHR Senior Investigator and Chair of the NIHR Doctoral Clinical and Practitioner Academic Fellowship (DCAF)