Short summary

Coercive interventions are used to prevent aggressive patients from harming others or themselves. The use of restraint can be highly stressful events for patients, nurses, and physicians. In Denmark, the use of restraint should be reduced by 50 percent for 2012 to 2020. However, the number of restraints and other coercive measures did not decrease as planned. Thus, we need more knowledge regarding the relationship between patient data and episodes of coercion. We create a local database includin

Rationale

Persons subject to coercion and in particular to mechanical restraint (MR) is a controversial issue in health policy and human rights organizations. In Denmark, there is a strong health policy focus on reducing the frequency and duration of coercion, as the European Committee against Torture and the UN Committee against Torture have criticized its use as ill-treatment by 2018. Thus, in 2014, the National Board of Health set a reduction of 50 percent in the use of MR by 2020. Therefore, the use of coercion and especially MR can be seen as the last resort in mental health care for aggressive, suicidal and psychotic patients. A meta-analysis revealed that male patients, history of violence, alcohol abuse, patients who were involuntarily admitted, and patients with a schizophrenia diagnosis predicted violence against staff in acute wards. Similarly, studies show that patients' impulsivity / hostility, longer hospital stays and if the aggressor and victim are of same sex increases the incidences of coercion.

The data are regarding all incidents with informations on time for incidents and date for admission to the hospital. The data are filed under the national security number. The data are regarding all incidents with informations on time for incidents and date for admission to the hospital. The data are filed under the national security number.

Aim: To establish a coercion database to uncover patterns of occurrences of coercive episodes and to develop interventions to prevent new episodes.

Description of the cohort

The cohort consists of all patients exposed to coercion at the psychiatric ward in Esbjerg. The first patient is included in the database when the database is established and when it can supply data to the national compulsory database. Patients are included until December 2023, unless permission is granted for an extension.

Data and biological material

Data is obtained from patient records regarding CPR number, age, sex, date of admission, hospital and section, deprivation of liberty, forced treatments and coercive measures with information on time, duration, prescription and justification with indication of type of coercion. Data about follow-up (coordination plan and printing agreements) is also collected. This data is provided to the national enforcement database.

In addition to the above, data include: diagnosis, abuse, prior notification, possible legal measures, municipality, known/unknown patient, associated local psychiatry, time of admission and BVC score prior to compulsive episodes. This data is archived only in the local database.

Collaborating researchers and departments

Center for Psykiatrisk Sygepleje- og sundhedsforskning (CPS)

• Professor Frederik Gildberg