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[Coercive interventions: historical summary and review of subjective experience]
Monika Edlinger1, Tobias Bader2, Alex Hofer2
1Medizinische Universität Innsbruck, Department für Psychiatrie, Psychotherapie und Psychosomatik, Univ.-Klinik für Psychiatrie I, Anichstr. 35, 6020, Innsbruck, Österreich. monika.edlinger@i-med.ac.at.
Abstract:
Psychiatric treatment has always been associated with violence and coercion. Involuntary admission and coercive measures are still frequently occurring components in everyday clinical practice.Up to 15% of psychiatric inpatients experience coercive treatment at least once during hospital stay. Particularly patients suffering from schizophrenia, organic mental disorders and mania have a high risk for such incidents.There is an ongoing intense debate on the need and justification of coercive measures, although most clinicians and scientists currently agree that there is no alternative. Several investigations have shown that seclusion and mechanical restraint go along with physical and psychological problems affecting both, patients and staff. However, it was possible to identify aspects that could be improved: Maintaining an objective and professional communication during coercive treatment seems just as important as making comprehensible decisions. Alternative treatment options should be focus of further investigations.
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