On 22–26 June, a delegation from Ukraine’s regional mental health services and Ministry of Health, and the WHO Country Office in Ukraine travelled to Liverpool, United Kingdom, for a study visit to Mersey Care NHS Foundation Trust, focused on reducing seclusion and restraint in mental health care settings.
The visit aimed to support Ukraine’s ongoing transformation of its mental health system, a shift from institutional, coercive models of care toward services that are person-centred, community-oriented and grounded in human rights. The visit came as part of the European Union-funded project, Health Resilience in the Eastern Partnership, which includes strengthening of mental health services in Eastern Partnership countries, including Ukraine, and was also supported by the Government of Canada.
Over the past decade, and with renewed urgency since the start of the war in 2022, Ukraine has been transforming its mental health system with the support of WHO. A new Law on Mental Health and the development of community-based services – including the rollout of Community Mental Health Centres and the shift of inpatient care from psychiatric settings into general hospitals – mark a fundamental move away from institutional models.
Alongside these structural changes, the All-Ukrainian Mental Health Programme “How Are You?”, initiated by First Lady Olena Zelenska in 2022, has been building a broader culture of mental health awareness and help-seeking across society.
Together, these efforts reflect a national commitment to a system that is community-based, recovery-oriented and grounded in human rights, while responding to the enormous mental health needs generated by war.
Reducing the use of seclusion and restraint in psychiatric settings remains one of the important steps on this path. Seclusion and restraint are practices that can lead to physical and mental harm, and are currently prevalent across many countries.
Seclusion means confining someone alone in a space they cannot leave, whether by locking a door, blocking access or telling them (or implying) they will face consequences if they try to leave.
Restraint refers to physically holding a person down, using equipment to limit their movement or providing medication to control their behaviour.
These practices often continue not because they are necessary, but because of outdated rules, habits and workplace cultures that have normalized them. WHO/Europe is working with countries, including Ukraine, to change this, replacing coercion with care that protects people’s dignity and rights.
Mersey Care NHS Foundation Trust has a long-standing, internationally recognized approach to reduce restrictive practices. Its “No Force First” programme reframed every use of force as a treatment failure to be reviewed, not an accepted feature of care.
This led to the development of the HOPE(S) model, a human rights-based approach to reducing long-term segregation, now adopted nationally across NHS England and recognized with awards from the Restraint Reduction Network.
Since 2019, Mersey Care has also supported WHO/Europe in implementing QualityRights training region-wide, recently co-leading a QualityRights community of practice with 11 countries. Its experience offers transferable lessons in leadership, culture change and governance, exactly where Ukraine is focusing its efforts.
Why this matters
Reducing seclusion and restraint sits at the heart of WHO QualityRights guidance. Coercive practices cause lasting harm to those subjected to them, and reducing them takes more than policy, it takes leadership and cultural change.
Study visits like this one turn that guidance into practical, tangible action. For Ukraine, learning directly from a system further along this path is invaluable.
About the project
The Health Resilience in the Eastern Partnership project is a multi-year collaboration between WHO/Europe and the European Commission’s Directorate-General for Enlargement and Eastern Neighbourhood.
As part of the project, WHO/Europe is supporting countries in building the skills and capacities of the health and care workforce, enabling them to expand access to quality, rights-based mental health care and support service transformation across the region.
This study visit was also made possible through the support of the Government of Canada, which funds WHO’s work in Ukraine to develop human rights-based and recovery-oriented mental health services.