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Coercive procedures and facilities in Swiss psychiatry
Ian Needham1, C Abderhalden, T Dassen
1Kantonale Psychiatric Hospital, CH-9500 Wil, Switzerland. needham@bluewin.ch
Swiss Medical Weekly
|July 31, 2002
Summary
Psychiatric wards show varied use and recording of coercive measures like seclusion and restraint. Improved facilities and staff training are needed for better coercion management and patient safety.
Area of Science:
- Psychiatry
- Mental Health Services Research
Background:
- Coercive measures in psychiatry, while effective for violence management, face criticism.
- There is a need to understand the current practices and perceptions of these measures.
Purpose of the Study:
- To survey the facilities, procedures, and recording of coercive measures in psychiatric acute admission wards.
- To identify deficits and areas for improvement in coercion management.
Main Methods:
- A questionnaire was sent to charge nurses of 86 acute psychiatric wards in German-speaking Switzerland.
- The survey covered 75% of the Swiss population's psychiatric care facilities.
Main Results:
- 95% of wards responded, indicating a representative sample.
- Most wards utilize seclusion rooms, with 55% deeming them adequate.
- Significant variations exist in the registration of coercive measures, including injections, seclusion, and mechanical restraint.
Conclusions:
- Coercive treatments like isolation, forced medication, and restraint require careful management.
- Identified deficits highlight the need for enhanced facilities and staff training in managing dangerous patients and mechanical restraints.