Search

Introduction: This research project“Reducing mechanical restraint in forensic mental health" addresses the national and international call and on-going need for a reduction in the use of coercive measures in forensic mental health settings (FMHS) (Hui et al., 2016, Ministry of Health 2013, Steinert 2016). Despite the fact that research-based interventions, such as "Safewards” (Bowers et al., 2015), has been implemented, the use of coercive measures remains a significant clinical problem in Denmark (Danish Health Authority 2020). Aim: To develop, validate, and evaluate a targeted interventions catalogue developed from previous research in order to reduce the use and duration of mechanical restraint episodes in FMHS.Design and method: An overall research approach rooted in the methodology of American pragmatism (Blumer 1986) is utilized in the following methods: Qualitative analysis of existing data regarding perceptions of conflict situations and mechanical restraint episodes in FMHS from a patient, relative and staff perspective (Tingleff et al. 2019a, Tingleff et al. 2019b Gildberg et al. 2021). Systematic literature review of evidence-based interventions to reduce coercive measures in mental health settings. Single interviews and focus group interview with patients, relatives and staff in FMHS.Expected outcome: Having developed an intervention catalogue, the results will be implemented in FMHS with the expected outcome to prevent use of and reduce the duration of mechanical restraint episodes. Thereby, the results has potential to contribute to a safer environment for patients and staff in FMHS, and increase both patient and relatives’satisfaction with forensic services.

I dette kapitel beskrives, hvilke oplevelser og erfaringer patienteri psykiatrien har i forhold til forskellige typer af tvangsforanstaltninger,der kan anvendes i en klinisk, psykiatriskpraksis. Dette beskrives i relation til de situationer, der er knyttet til anvendelsen af tvangsforanstaltninger, dvs. situationer før, under og efter tvang. Sammenhængen mellem patientens voldelige adfærd og anvendelsen af tvang uddybes ved hjælp af forklaringsmodeller, og ligeledes giver kapitlet anledningtil, at sygeplejersken kritisk reflekterer over egen rolle i konfliktsituationermed patienten, ved at forstå konflikter som en dynamisk bevægelse mellem flere involverede parter. Endelig beskrives patienternes perspektiver på, hvorledes anvendelse af tvang kan reduceres, ligesom der uddybes med oplysningerom, hvordan der aktuelt arbejdes med at reducere anvendelsen af tvang i Danmark.