ReviewDeutsches Arzteblatt international2019
Measures to Avoid Coercion in Psychiatry and Their Efficacy.
Review in Deutsches Arzteblatt international, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
50 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Post-incident debriefing for people with schizophrenia after coercive measures.The Cochrane database of systematic reviews · 2025Pooled it
- Is mental health staff training in de-escalation techniques effective in reducing violent incidents in forensic psychiatric settings? - A systematic review of the literature.BMC psychiatry · 2023Pooled it
- Models, frameworks and theories in the implementation of programs targeted to reduce formal coercion in mental health settings: a systematic review.Frontiers in psychiatry · 2023Pooled it
- Can primary mental health services impact levels of involuntary admissions? A cluster-RCT of the ReCoN intervention.Social psychiatry and psychiatric epidemiology · 2025Trial
- Barriers and Facilitators-Lessons Learned From a Randomised Trial to Implement Clinical Practice Guidelines for the Prevention of Coercion in Psychiatry.International journal of mental health nursing · 2025Trial
- Relationship between perceived coercion and perceived justification of coercive measures - secondary analysis of a randomized-controlled trial.BMC psychiatry · 2023Trial
- Implementing modular competence-oriented psychotherapy in inpatient psychiatry: a three-year analysis of restraint and seclusion.BMC psychiatry · 2026Article
- Abolition of coercion in psychiatry on the horizon? A descriptive ecologic data study from six European countries.European psychiatry : the journal of the Association of European Psychiatrists · 2026Article
- Team Collaboration Experiences of Nurses and Physicians Working in Inpatient Psychiatry Units Related to Physical Restraint Practices: A Qualitative Study.Florence Nightingale journal of nursing · 2025Article
- "A pilot study of MAP - a program for handling of aggressive behaviour in psychiatric wards. An evaluation of mediating mechanisms".BMC medical education · 2025Article
- Staff Attitude Towards Coercive Measures in Hospital and Community Psychiatric Settings.Journal of clinical medicine · 2025Article
- An Exploratory Study about Factors and Outcomes Associated with the Experience of Coercive Measures in Mental Health Settings.The Psychiatric quarterly · 2025Article
- Predictive accuracy of the Violence Risk Assessment Checklist for Youth in acute institutions: A prospective naturalistic multicenter study.European psychiatry : the journal of the Association of European Psychiatrists · 2025Observational
- Maximising relational capabilities and minimising restrictive practices in acute mental health units: the Safe Steps for De-escalation evaluation.Frontiers in psychiatry · 2025Article
- Evaluating the Safe Steps for De-escalation: A protocol for a mixed concurrent control study in acute mental health units.PloS one · 2025Article
- Novel Approaches Needed: An Experimental Study with an Alternative to Mechanical Restraint.Healthcare (Basel, Switzerland) · 2024Article
- Interrater reliability of the violence risk assessment checklist for youth: a case vignette study.BMC psychiatry · 2024Article
- Something Happened with the Way We Work: Evaluating the Implementation of the Reducing Coercion in Norway (ReCoN) Intervention in Primary Mental Health Care.Healthcare (Basel, Switzerland) · 2024Article
- Factors and Processes Facilitating Recovery from Coercion in Mental Health Services-A Meta-Ethnography.Healthcare (Basel, Switzerland) · 2024Review
- Effect of Seclusion on Mental Health Status in Hospitalized Psychiatric Populations: A Trial Emulation using Observational Data.Evaluation & the health professions · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCoercive measures such as seclusion and restraint encroach on the patient's human rights and can have serious adverse effects ranging from emotional trauma to physical injury and even death. At the same time, they may be the only way to avert acute danger for the patient and/or the hospital staff. In this article, we provide an overview of the efficacy of the measures that have been studied to date for the avoidance of coercion in psychiatry.
methodsThis review is based on publications retrieved by a systematic search in the Medline and Cinahl databases, supplemented by a search in the reference lists of these publications. We provide a narrative synthesis in which we categorize the interventions by content.
resultsOf the 84 studies included in this review, 16 had a control group; 6 of these 16 were randomized controlled trials (RCTs). The interventions were categorized by seven different types of content: organization, staff training, risk assessment, environment, psychotherapy, debriefings, and advance directives. Most interventions in each category were found to be effective in the respective studies. 38 studies investigated complex treatment programs that incorporated elements from more than one category; 37 of these (including one RCT) revealed effective reduction of the frequency of coercion. Two RCTs on the use of rating instruments to assess the risk of aggressive behavior revealed a relative reduction of the number of seclusion measures by 27% and a reduction of the cumulative duration of seclusion by 45%.
conclusionComplex intervention programs to avoid coercive measures, incorporating elements of more than one of the above categories, seem to be particularly effective. In future, cluster-randomized trials to investigate the individual categories of intervention would be desirable.
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Registered trials
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