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[Are coercive measures carried out arbitrarily?].

T Steinert1, R P Gebhardt

  • 1Abteilung Psychiatrie I der Universität Ulm. tilman-steinert@zfp-weissenau.de

Psychiatrische Praxis
|October 29, 2000
PubMed
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Psychiatric coercive measures like seclusion and restraint are not arbitrary. This study found they are predominantly linked to patients

Area of Science:

  • Psychiatry
  • Clinical Psychology

Context:

  • Media reports and psychiatric literature suggest arbitrary use of coercive measures (seclusion, restraint, forced medication) in psychiatric hospitals.
  • This perception necessitates an empirical investigation into the actual indications for these interventions.

Purpose:

  • To investigate the association between psychopathological symptom severity, patient aggression, and the application of coercive measures in psychiatric settings.
  • To determine if coercive measures are applied arbitrarily or are indicated by specific patient behaviors and symptomology.

Summary:

  • A study of 193 psychiatric treatment episodes analyzed psychopathology using the PANSS and aggression with the Modified Overt Aggression Scale (MOAS).
  • Coercive measures were applied in 24.3% of cases. Patients subjected to these measures exhibited MOAS scores six times higher than those not subjected to them.

Related Experiment Videos

  • A significant correlation was found, with 56% of coercive measures occurring in the most psychopathological quarter of patients, and none in the least psychopathological quarter (p < 0.0001).

    • Impact:

    • Findings challenge the presumption of arbitrary application of coercive measures in psychiatric hospitals.
    • The study indicates that psychopathology and patient aggression are the primary drivers for the use of seclusion, restraint, and forced medication.
    • This research provides evidence-based insights for refining clinical practices and policies regarding the use of coercive interventions in mental healthcare.