Patients' preferences for seclusion or forced medication in acute psychiatric emergency in the Netherlands

This study examined patients' preferences for coercive measures in case of emergency situations on acute psychiatric wards.

From November 2004 until January 2006, 104 adult patients completed a questionnaire after they underwent seclusion, nonconsensual medication, or both on one of three acute psychiatric wards in the Netherlands.

Equal numbers of patients preferred seclusion and medication, and both measures were equal in perceived aversiveness and perceived efficacy. Men more often than women expressed a preference for seclusion. Patients who understood why the measure was necessary and acquiesced to it retrospectively held more positive views of the efficacy of the measure.

Many patients on acute psychiatric wards have a clear preference between seclusion and medication. Patients appreciated receiving explanations of the reasons for the use of a restrictive measure and discussing their preferences with staff.