“…The need to minimize manual restraint practice has been reflected globally through the introduction of guidelines, policies, and programs advocating for its reduction and, where possible, elimination (e.g., Bowers et al, 2015;Department of Health, 2014;Duxbury, Baker, et al, 2019;Mental Health Commission, 2014;O'Hagan et al, 2008;Royal Australian and New Zealand College of Psychiatrists, 2021). This is not surprising considering that manual restraint has been linked to service user death (Duxbury et al, 2011;Nunno et al, 2022), service user and staff distress (Bigwood & Crowe, 2008;Cusack et al, 2018), staff misuse (Brophy et al, 2016;Lee et al, 2003), and staff and service user injury (Lee et al, 2003;Wilson et al, 2017). The development and implementation of multimodal restraint and restrictive intervention minimization programs such as "Safewards," "No Force First," and "REsTRAIN Yourself" have successfully led to reductions in manual restraint rates ranging from 19% to 26% within inpatient mental health, older adult, and learning disability settings (Bowers et al, 2015;Duxbury, Baker, et al, 2019;Haines-Delmont et al, 2022), highlighting that not all instances of manual restraint are necessary.…”