The Netherlands has been plunged into a debate about how to deal with violent psychiatric patients, after images of a tethered teenager appeared on Dutch TV.
The pictures were taken after a tip-off from a whistle-blower, who worked at the institution where the 18-year-old, known only as Brandon, is confined.
The pictures show him wearing a harness attached to a metal bracket on the wall by a thick leather strap.
He has been confined in this way every single day for three years.
His mother has been quoted saying he lives like “a caged animal”.
Brandon, who suffers from severe learning difficulties, has been confined to institutions since the age of five.
He used to be allowed home at weekends but staff became increasingly afraid of his moods as he grew older and, since 2007, with the permission of a judge, he has been tethered daily.
Mental health experts in the Netherlands say this is not an isolated case, and there may be as many as 40 patients held in similar circumstances.
But a number of Dutch politicians reacted with shock when the pictures of Brandon were shown on television and there was an emergency debate in parliament.
The deputy health minister, who visited the institution where Brandon is confined, described the images as truly harrowing.
She defended the practice of continuous restraint, saying sometimes you need to protect people from themselves, but also promised an urgent review, to see if any other methods could be used.