NDLI: Methodological issues in monitoring the use of coercive measures.

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Methodological issues in monitoring the use of coercive measures.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Janssen, W. A. Van De Sande, R. Noorthoorn, E. O. Nijman, H. L. I. Bowers, L. Mulder, C. L. Smit, A. Widdershoven, G. A. M. Steinert, T.
Spatial Coverage	Netherlands Europe
Description	Country affiliation: Netherlands Author Affiliation: Janssen WA ( Kenniscentrum GGNet, Warnsveld, The Netherlands. wim.janssen@ggnet.nl)
Abstract	PURPOSE: In many European countries, initiatives have emerged to reduce the use of seclusion and restraint in psychiatric institutions. To study the effects of these initiatives at a national and international level, consensus on definitions of coercive measures, assessment methods and calculation procedures of these coercive measures are required. The aim of this article is to identify problems in defining and recording coercive measures. The study contributes to the development of consistent comparable measurements definitions and provides recommendations for meaningful data-analyses illustrating the relevance of the proposed framework. METHODS: Relevant literature was reviewed to identify various definitions and calculation modalities used to measure coercive measures in psychiatric inpatient care. Figures on the coercive measures and epidemiological ratios were calculated in a standardized way. To illustrate how research in clinical practice on coercive measures can be conducted, data from a large multicenter study on seclusion patterns in the Netherlands were used. RESULTS: Twelve Dutch mental health institutes serving a population of 6.57 million inhabitants provided their comprehensive coercion measure data sets. In total 37 hospitals and 227 wards containing 6812 beds were included in the study. Overall seclusion and restraint data in a sample of 31,594 admissions in 20,934 patients were analyzed. Considerable variation in ward and patient characteristics was identified in this study. The chance to be exposed to seclusion per capita inhabitants of the institute's catchment areas varied between 0.31 and 1.6 per 100.000. Between mental health institutions, the duration in seclusion hours per 1000 inpatient hours varied from less than 1 up to 18h. The number of seclusion incidents per 1000 admissions varied between 79 up to 745. The mean duration of seclusion incidents of nearly 184h may be seen as high in an international perspective. CONCLUSION: Coercive measures can be reliably assessed in a standardized and comparable way under the condition of using clear joint definitions. Methodological consensus between researchers and mental health professionals on these definitions is necessary to allow comparisons of seclusion and restraint rates. The study contributes to the development of international standards on gathering coercion related data and the consistent calculation of relevant outcome parameters.
File Format	HTM / HTML
ISSN	01602527
Issue Number	6
Volume Number	34
e-ISSN	18736386
Journal	International Journal of Law and Psychiatry
Language	English
Publisher	Elsevier
Publisher Date	2011-11-01
Publisher Place	Netherlands
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Jurisprudence Discipline Psychiatry Coercion Drug Therapy Statistics & Numerical Data Hospitals, Psychiatric Mental Disorders Therapy Patient Isolation Restraint, Physical Standards Europe Humans Netherlands Journal Article Multicenter Study
Content Type	Text
Resource Type	Article
Subject	Law Pathology and Forensic Medicine Psychiatry and Mental Health

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Variation in use of coercive measures in psychiatric hospitals.

Use of coercive physical measures in a psychiatric ward of a general hospital in Greece.

Quality of Life and Functioning One Year After Experiencing Accumulated Coercive Events During Psychiatric Admission.

Regulatory change: a pathway to eliminating seclusion and restraint or 'regulatory scotoma'?

The use of seclusion in the Netherlands compared to countries in and outside Europe.

Seclusion reduction in a forensic mental health setting.

A randomized controlled comparison of seclusion and mechanical restraint in inpatient settings.

Should psychiatrists assist in the restraint of children and adolescents in psychiatric facilities?

Commentary: commentary on the 'choice' between seclusion and forced medication.

Methodological issues in monitoring the use of coercive measures.

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Variation in use of coercive measures in psychiatric hospitals.

Use of coercive physical measures in a psychiatric ward of a general hospital in Greece.

Quality of Life and Functioning One Year After Experiencing Accumulated Coercive Events During Psychiatric Admission.

Regulatory change: a pathway to eliminating seclusion and restraint or 'regulatory scotoma'?

The use of seclusion in the Netherlands compared to countries in and outside Europe.

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