Coercive measures used during hospitalization. Eunomia - final results in the Czech Republic

Abstract

Background:

The EUNOMIA international project focuses on the application of coercive measures in psychiatric treatment. The use of coercive measures to mentally ill people is a very sensitive topic. The type and frequency of this action is influenced by different cultural or legal traditions, general attitudes toward mentally ill people and the structure and quality of mental health care systems.

Aims:

Presentation of the frequency and way of administration of coercive measures to psychiatric inpatients with acute mental illness in the Czech Republic.

Methods:

All coercive measures used during hospitalization (restraint, seclusion, forced medication) were documented in detail in special form. The definition of coercive measures was following: Restraint - fixation of at least one limb for longer than 15 minutes. Forced medication – the use of restraint or high psychological pressure to administer medication.Seclusion -involuntary placement of the patient alone in a locked room.

Results:

We have evaluated the group of 202 involuntarily admitted patients and the group of 59 voluntarily admitted patients perceiving some coercion at admission.

Restraint, forced medication or/ and seclusion were used in 45,5% of involuntarily admitted patients. In 2/3 of these patients some coercive measure was repeated. In the group of voluntarily admitted patients coercive measures were used only marginally (5,1%).

The most frequent measure used was forced medication. Mainly typical antipsychotics and benzodiazepins were administered.

Conclusion:

Presented results show the praxis with the use of coercive measures in the Czech Republic. The data were gathered within the EUNOMIA project.