The big conversation: understanding restrictive practice in the community

18 July 2025

What does it really mean when people talk about ‘restrictive practice’ in mental health care? How does it show up in everyday life for people living in the community, and what would it take to change it together?

The big conversation is a project led by us at Sheffield Health and Social Care NHS Foundation Trust (SHSC), with SACMHA Health and Social Care as our main community partner. It’s all about listening to people with lived experience and working with them to create real change.

Instead of starting with official definitions or top-down ideas, this project began by asking the people most affected - those who’ve experienced restrictions in the community - what it means to them. Their voices are guiding every step.

At its heart, the big conversation is about understanding and making change happen. We want to learn where and how restrictions happen in people’s lives, and why. Then, together, we want to come up with ideas for how things could be better, fairer, and more supportive.

Project phases

The project is happening in stages:

March to April 2025

In the first two months we focused on building trust and designing the project together. We worked with service users and families to come up with the key questions and develop tools that are safe, respectful, and based on people’s real experiences. Together, we began exploring what the term ‘restrictive practice’ really means in everyday life.

May to September 2025

Between May and September we are holding in-depth conversations and group workshops. People with lived experience won’t just be participants, they’ll help lead the work. They’ll be involved in looking at what we’re hearing, spotting patterns, and shaping early ideas. Each stage will build on the last, so the work stays flexible and keeps listening to what people say.

By the end of 2025

The big conversation will share what we’ve learned through stories, reports, and a clear plan for how to make things better. These won’t be just words on paper - they’ll be real-life experiences turned into practical steps that can lead to lasting change.
 

One of the most important parts of this project is keeping the conversation going. SACMHA’s role as a trusted local organisation helps make sure the work stays connected to the community. SHSC and SACMHA are committed to making this more than a one-off project. It’s the start of long-term change led by the people who know the issues best.

Of course, this work isn’t easy. Talking about restriction can bring up painful memories. And many people feel let down by systems that haven’t listened before. That’s why we’re working in a trauma-informed way, making the process as safe, flexible, and supportive as possible. Peer support and community-led sessions are key to that.

In the end, the big conversation is about voice, power, and care. It asks: What does freedom and safety really look like in mental health care? And how can we work together, across services and communities, to make that vision real?

This isn’t just research. It’s an invitation to listen better, share power, and build something new, together.