1. Use of coercive measures during involuntary hospitalization: findings from ten European countries
- Author
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Georgi Onchev, Stefan Priebe, Lucie Kališová, Andrzej Kiejna, Alexander Nawka, Eva Kitzlerová, Francisco Torres-Gonzales, Lorenza Magliano, Anastasia Karastergiou, Algirdas Dembinskas, Lars Kjellin, Thomas W. Kallert, Jiri Raboch, Raboch, J, Kalisová, L, Nawka, A, Kitzlerová, E, Onchev, G, Karastergiou, A, Magliano, Lorenza, Dembinskas, A, Kiejna, A, TORRES GONZALES, F, Kjellin, L, Priebe, S, and Kallert, Tw
- Subjects
Adult ,Hospitals, Psychiatric ,Male ,medicine.medical_specialty ,coercion, psychiatric patients ,Coercion ,Severity of illness ,medicine ,Humans ,Prospective Studies ,Psychiatry ,Aggression ,business.industry ,Public health ,Social environment ,Middle Aged ,Mental health ,Europe ,Hospitalization ,Psychiatry and Mental health ,Involuntary treatment ,Commitment of Mentally Ill ,Female ,medicine.symptom ,business ,Seclusion ,Diagnosis of schizophrenia - Abstract
Objective: Involuntary treatment in mental health care is a sensitive but rarely studied issue. This study was part of the European Evaluation of Coercion in Psychiatry and Harmonization of Best Clinical Practice (EUNOMIA) project. It assessed and compared the use of coercive measures in psychiatric inpatient facilities in ten European countries. Methods: The sample included 2,030 involuntarily admitted patients. Data were obtained on coercive measures (physical restraint, seclusion, and forced medication). Results: In total, 1,462 coercive measures were used with 770 patients (38%). The percentage of patients receiving coercive measures in each country varied between 21% and 59%. The most frequent reason for prescribing coercive measures was patient aggression against others. In eight of the countries, the most frequent measure used was forced medication, and in two of the countries mechanical restraint was the most frequent measure used. Seclusion was rarely administered and was reported in only six countries. A diagnosis of schizophrenia and more severe symptoms were associated with a higher probability of receiving coercive measures. Conclusions: Coercive measures were used in a substantial group of involuntarily admitted patients across Europe. Their use appeared to depend on diagnosis and the severity of illness, but use was also heavily influenced by the individual country. Variation across countries may reflect differences in societal attitudes and clinical traditions. (Psychiatric Services 61: 1012-1017, 2010)
- Published
- 2010