How to prevent Coercion in Danish Mental Health Care-A Longitidinal Cluster Study

Jesper Bak*, Lene Lauge Berring (Member of author group), Frederik Gildberg (Member of author group), Jens Peter Hansen (Member of author group), Peter Hjorth (Member of author group), Rikke Jørgensen, Mette Kragh (Member of author group), Sanne Lemcke (Member of author group), Helle Schnor, Jacob Christian Hvidhjelm (Member of author group)

*Corresponding author for this work

Research output: Contribution to conference without publisher/journalConference abstract for conferenceResearchpeer-review

Abstract

Background: The use of physical coercive measures, e.g. mechanical restraint (MR), in mental health care, is a major infringement on the psychiatric patient’s autonomy. MR can cause physical and mental harm but may be necessary to avoid putting an individual’s health at risk. The nursing staff is tasked with protecting the life and health of, not only the individual patient, but also other patients, and relatives. A situation can occur in which staff is obligated to use force, and occasionally MR, if a patient is very aggressive, violent, self-destructive, or suicidal. Although MR is legal, the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment concluded, in three reports from 2002, 2008, and 2014 that no medical justification exists for applying instruments of physical restraint to psychiatric patients for days, and that doing so amounts to ill treatment. Following, the Government in Denmark decided in 2014, that the number of MR should be halved before 2020. This decision lead to development, and implementation of an array of more or less, evidence based preventive initiatives. In some regions, the development has been positive, reducing the numbers of MR episodes, but we do not know which initiatives has created this development. Aim: To examine which MR preventive factors/initiatives reduces the number of MR episodes. Methods: This study is designed as a nationwide, longitudinal, cluster, cross-sectional survey of preventive initiatives implemented in psychiatric units and the corresponding numbers of coercive episodes. Questionnaires will be used to gather data on preventive initiatives from the units’ once a year, over a period of three years, and data on coercive episodes will be accessed from the national database on coercion. A linear mixed-method model will be used to estimate the longitudinal effect of implementing the specific preventive initiatives. Results: The only data collected at the time of the conference will be from 2016, so descriptive data will be presented, together with data on coercive episodes.
Original languageEnglish
Publication dateMay 2018
Publication statusPublished - May 2018
EventHoratio Congress 2018: Safe Settings - Nordic House, Thorshavn, Faroe Islands
Duration: 10. May 201812. May 2018

Conference

ConferenceHoratio Congress 2018
LocationNordic House
CountryFaroe Islands
CityThorshavn
Period10/05/201812/05/2018

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