ArticleBMC psychiatry2019
Trends in the use of coercive measures in Finnish psychiatric hospitals: a register analysis of the past two decades.
Article in BMC psychiatry, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02724748 (The Effectiveness of User-driven Intervention to Manage Patient Aggression in Mental Health Services), which is not on this map. Cited by 11 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
The Effectiveness of User-driven Intervention to Manage Patient Aggression in Mental Health Services
Who cites it
11 citing papers in PubMed, 3 syntheses or guidelines pooled it, 27 citations in OpenAlex.
- Post-incident debriefing for people with schizophrenia after coercive measures.The Cochrane database of systematic reviews · 2025Pooled it
- Mechanical restraint in inpatient psychiatric settings: A systematic review of international prevalence, associations, outcomes, and reduction strategies.European psychiatry : the journal of the Association of European Psychiatrists · 2025Pooled it
- Measurement Properties of the Staff Attitude to Coercion Scale: A Systematic Review.Frontiers in psychiatry · 2022Pooled it
- 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
- Effect of coercive measures on mental health status in adult psychiatric populations: a nationwide trial emulation.Epidemiology and psychiatric sciences · 2024Article
- Effect of Seclusion on Mental Health Status in Hospitalized Psychiatric Populations: A Trial Emulation using Observational Data.Evaluation & the health professions · 2024Article
- [Monitoring of coercive measures and compulsory treatment in Germany].Der Nervenarzt · 2022Review
- Physical Restraint Events in Psychiatric Hospitals in Hong Kong: A Cohort Register Study.International journal of environmental research and public health · 2022Article
- Quality of mental health services and rights of people receiving treatment in inpatient services in Finland: a cross-sectional observational survey with the WHO QualityRights Tool Kit.International journal of mental health systems · 2021Article
- Number of Seclusions in the Netherlands Higher in the 7 Years Since the End of a Nationwide Seclusion-Reduction Program.Frontiers in psychiatry · 2021Article
- A tool to evaluate proportionality and necessity in the use of restrictive practices in forensic mental health settings: the DRILL tool (Dundrum restriction, intrusion and liberty ladders).BMC psychiatry · 2020Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 4 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCoercive measures is a topic that has long been discussed in the field of psychiatry. Despite global reports of reductions in the use of restraint episodes due to new regulations, it is still questionable if practices have really changed over time. For this study, we examined the rates of coercive measures in the inpatient population of psychiatric care providers across Finland to identify changing trends as well as variations in such trends by region.
methodsIn this nationwide registry analysis, we extracted patient data from the national database (The Finnish National Care Register for Health Care) over a 20-year period. We included adult patients admitted to psychiatric units (care providers) and focused on patients who had faced coercive measures (seclusion, limb restraints, forced injection and physical restraints) during their hospital stay. Multilevel logistical models (a polynomial model of quadratic form) were used to examine trends in prevalence of any coercive measures as well as the other four specified coercive measures over time, and to investigate variation in such trends among care providers and regions.
resultsBetween 1995 and 2014, the dataset contained 226,948 inpatients who had been admitted during the 20-year time frame (505,169 treatment periods). The overall prevalence of coercive treatment on inpatients was 9.8%, with a small decrease during 2011-2014. The overall prevalence of seclusion, limb restraints, forced injection and physical restraints on inpatients was 6.9, 3.8, 2.6 and 0.8%, respectively. Only the use of limb restraints showed a downward trend over time. Geographic and care provider variations in specific coercive measures used were also observed.
conclusionsDespite the decreasing national level of coercive measures used in Finnish psychiatric hospitals, the overall reduction has been small during the last two decades. These results have implications on the future development of structured guidelines and interventions for preventing and more effectively managing challenging situations. Clinical guidelines and staff education related to the use of coercive measures should be critically assessed to ensure that the staff members working with vulnerable patient populations in psychiatric hospitals are ethically competent.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.