Citation

Birkeland S. J. Forensic Psychiatry Psychol. 2018; 29(1): 99-105.

Copyright

(Copyright © 2018, Informa - Taylor and Francis Group)

DOI

10.1080/14789949.2017.1342271

PMID

unavailable

Abstract

Coercive measures like mechanical restraint (MR) are widely used in psychiatry but may collide with bioethical autonomy principles, damage those involved, and harm patient-staff relations. Reductions in usage are desirable and addressing illegitimate MR would be an obvious starting point. As one important reason for instigating MR is dangerous patient behavior this attracts special attention. In this complaints audit the role of threats, violence, and contextual characteristics was examined in decisions concerning MR completed by the Danish Psychiatric Patient Complaint Board system from 2007 to 2014. According to case descriptions, threats and violence were common and sometimes rather serious. Mainly actualized physical violence seemed to justify MR use. However, roughly every sixth patient subject to MR episodes filed a complaint and in one in 25, usage was found unlawful. The interpretation of clinical situations vs. law elements and surrounding coercion legislation needs further investigation as does the impact of, e.g. psychiatry staffing.

Language: en

Keywords

law; mechanical restraint; Psychiatry; violence