Almost two years on from the heartbreaking death of Codie Lee Black, 18, her family and friends want to see changes in the law to protect those in mental health care from what her mum called “brutal treatment of vulnerable patients”.
The Walker teenager’s family want to see legal changes to guidelines for the use of “restrictive restraints” on mental health wards. These can involve a patient being physically or chemically restrained, and there has long been pressure from politicians and charities to reduce the practice – which can cause injuries and psychological harm.
Codie’s family say she experienced this throughout lengthy time spent in mental health inpatient care. The teenager, who died in January 2023, had diagnoses of post-traumatic stress disorder and emotionally unstable personality disorder – and had struggled with her mental health following sexual abuse at 13, perpetrated by the relative of a friend.
Codie was a mental health inpatient at hospitals around the country, including in the North East. Her family said she had “suffered recurrent injuries due to heavy-handed” restraints.
Earlier this week, Codie’s mum Helen Black told ChronicleLive of her drive to get justice for Codie – who died following a sequence of failings at an inpatient unit the Cumbria, Northumberland, Tyne and Wear NHS Trust runs in Carlisle. Codie drowned in a bathroom at the Carleton Unit there. A coroner highlighted in December how failings which contributed to her death included that appropriate risk assessments of this and observations were not made.
Codie Lee Black – who died aged 18 in the care of NHS mental health services
(Image: Family handout)
Now the family also has a public petition calling for “Codie’s Law” – tighter guidelines on the use of restraint in mental health settings, which is something Codie experienced. Mum Helen said: “To get Codie’s Law would be amazing. She had so many friends in hospital and this would be Codie’s way of living on and protecting her friends. If she can make any difference, that would be amazing. Changing this would make such a massive impact on patients.”
Helen’s petition includes detail of what Codie went through. She writes: “For the last five years, my daughter was subject to mistreatment in mental hospitals. She suffered recurrent injuries due to heavy-handed restraint methods and practices.
“Her painful ordeal ended tragically on January 31, 2023, when she took her own life in the very place she should have been safe. In a twisted irony, no one restrained her on that fateful day—they left her alone in her moment of need—after multiple incidents of unnecessary and over-aggressive restraint.”
In response, the Department of Health and Social Care has committed that its new mental health bill will ensure those with severe mental health needs receive “better, more personalised treatment that is appropriate, proportionate, and compassionate to their needs”.
The CNTW NHS Trust manages mental health hospitals in much of our region. The trust’s executive medical director Dr Rajesh Nadkarni said that a program to reduce the use of restraint was ongoing and that while progress had been made, there was “still more to do”.
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Dr Nadkarni added that restraint was “only ever used when other options have been tried, to protect the person or those around them from serious harm”. The trust has previously been criticised for its use of restraint on wards – but says this has been reduced.
Dr Nadkarni, said: “Our thoughts are with Ms Black’s family and friends at this very difficult time. We cannot comment on the specifics of an individual’s care and treatment, but as an organisation we are dedicated to making sure that people are supported in the least restrictive way possible on our inpatient units.
“Restraining someone can be very distressing to patients and staff, and is only ever used when other options have been tried, to protect the person or those around them from serious harm. Our staff receive regular training, both in how to safely restrain someone as a last resort, and in ways to de-escalate situations wherever possible.”
Dr Nadkarni said a program to reduce restraint called ‘Talk First’ was in oeration and this “brings staff and patients together to make wards calmer and safer places”. He added: “It focuses on helping people to take part in meaningful, social activities, feeling less frustrated or agitated and, in turn, reducing the need for restraint..
“Staff discuss with patients and their families on their admission to a ward, how best to support them if they do become distressed. If an incident involving restraint occurs during their care after all other options have been exhausted, patients and staff are encouraged to ‘debrief’ so that they can understand and learn from the incident to reduce the need for restraint in future.”
The senior medic added that the trust had seen a “steady reduction in the use of restraint” but said: “We recognise there is still more to do. To continue progress in this area, we are also working closely with regulators, and ensure that any new national learning immediately feeds into our improvement plan.”
A Department of Health and Social Care spokesperson said: “Our deepest sympathies go out to Codie’s family and friends. Patient safety is paramount, and anyone receiving treatment in an inpatient mental health facility deserves safe, high-quality care, and to be treated with dignity and respect.
“Our Mental Health Bill will ensure that people with the most severe mental health conditions receive better, more personalised treatment that is appropriate, proportionate, and compassionate to their needs. We will also work with the NHS to transform care and recruit 8,500 more mental health workers across children and adult services to reduce delays and provide faster care.”
In theory, the Mental Health Units Use of Force Act 2018 brought in safeguards around this issue. According to the Care Quality Commission, it “aims to reduce the use of force and ensure accountability and transparency about the use of force in mental health services.”
The CQC adds: “Services are required to have a policy, co-produced with patients, that commits to reducing the use of force. Guidance for the Act also includes requirements over training, recording and reporting the use of force, and requires services to identify a Responsible person, who is accountable for implementing the Act.”
If this piece has affected you and you want to talk to someone, there are helplines and support groups available, many of them 24/7.
The NHS Choices website lists the following helplines and support networks for people to talk to.
- Samaritans (116 123 in UK and Ireland) operates a 24-hour service available every day of the year. If you prefer to write down how you’re feeling, or if you’re worried about being overheard on the phone, you can email Samaritans at jo@samaritans.org.
- Childline (0800 1111) runs a helpline for children and young people in the UK. Calls are free and the number won’t show up on your phone bill.
- PAPYRUS (0800 068 41 41) is a voluntary organisation supporting teenagers and young adults who are feeling suicidal.
- Mind (0300 123 3393) is a charity based in England providing advice and support to empower anyone experiencing a mental health problem. They campaign to improve services, raise awareness and promote understanding.
- Students Against Depression is a website for students who are depressed, have a low mood or are having suicidal thoughts.
- Bullying UK is a website for both children and adults affected by bullying.
- If U Care Share is a suicide prevention and postvention support charity. For free confidential text support text IUCS to 85258.
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James’ Place provide free, life-saving treatment for suicidal men, and those identifying as male, in the North East. Men can refer themselves or be referred by a professional including those working in health and community services, or by a friend or family member.