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Predicting use of coercive measures in Finland
Jyrki A Korkeila1, Carita Tuohimäki, Riittakerttu Kaltiala-Heino
1Department of Psychiatry, University of Turku, Turku, Finland. jyrki.korkeila@turku.fi
Nordic Journal of Psychiatry
|December 10, 2002
Summary
Psychiatric centers show significant variation in seclusion and restraint use. Institutional factors, not patient history, best predict overall restrictive measure use.
Area of Science:
- Psychiatry
- Mental Health Services Research
Background:
- Previous studies indicate substantial institutional variation in the application of seclusion and restraints within psychiatric treatment.
- Restrictive measures, including seclusion and restraints, are utilized in psychiatric care, but their prevalence and predictive factors remain areas for investigation.
Purpose of the Study:
- To investigate factors predicting the overall and "heavy use" of seclusion and restraints.
- To examine differences in population-based rates of seclusion and restraint use across three Finnish university psychiatric centers.
Main Methods:
- Retrospective chart review of all civil admissions for working-aged individuals over a 6-month period in 1996.
- Comparative analysis of seclusion and restraint utilization rates between the psychiatric centers in Turku, Tampere, and Oulu.
Main Results:
- Significant differences in population-based seclusion and restraint use were observed among the three centers.
- Oulu exhibited lower seclusion rates but higher restraint rates compared to Turku and Tampere.
- Individual institutional characteristics were the strongest predictors of overall restrictive intervention use.
Conclusions:
- Institutional factors significantly influence the use of seclusion and restraints in psychiatric settings.
- Previous commitments and involuntary legal status were associated with "heavy use" of these measures.
- Harmonization of the implementation and monitoring of restrictive measures is recommended.