Observational studyBMC psychiatry2021
Evaluation of coercive measures in different psychiatric hospitals: the impact of institutional characteristics.
Observational study in BMC psychiatry, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled 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
- Association of psychological resilience and social support with subjective coercion experience in hospitalized psychiatric inpatients: a cross-sectional study.Frontiers in public health · 2026Article
- Patient-related characteristics or local tradition: what predicts the admission to a locked ward or the use of coercive measures in psychiatric inpatient treatment?European archives of psychiatry and clinical neuroscience · 2025Observational
- Mental Health Nurses' Enforcement of Involuntary Care in Inpatient Settings: A Meta-Ethnography.International journal of mental health nursing · 2025Review
- [Implementation of an Open Door Policy on Two Acute Care Units].Psychiatrische Praxis · 2024Article
- Factors and Processes Facilitating Recovery from Coercion in Mental Health Services-A Meta-Ethnography.Healthcare (Basel, Switzerland) · 2024Review
- Physical Restraint Practices at the Emergency Department of a Mental Health Hospital.Psychiatry and clinical psychopharmacology · 2024Article
- Zero Tolerance for Coercion? Historical, Cultural and Organisational Contexts for Effective Implementation of Coercion-Free Mental Health Services around the World.Healthcare (Basel, Switzerland) · 2023Article
- The association between the admission to wards with open- vs. closed-door policy and the use of coercive measures.Frontiers in psychiatry · 2023Article
- Treatment without consent in adult psychiatry inpatient units: a retrospective study on predictive factors.Frontiers in psychiatry · 2023Article
- Open Doors by Fair Means: a quasi-experimental controlled study on the effects of an open-door policy on acute psychiatric wards.BMC health services research · 2022Article
- Physical Restraint Events in Psychiatric Hospitals in Hong Kong: A Cohort Register Study.International journal of environmental research and public health · 2022Article
- Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
backgroundEpidemiological studies have demonstrated considerable differences in the use of coercive measures among psychiatric hospitals; however, the underlying reasons for these differences are largely unclear. We investigated to what extent these differences could be explained by institutional factors.
methodsFour psychiatric hospitals with identical responsibilities within the mental health care system, but with different inpatient care organizations, participated in this prospective observational study. We included all patients admitted over a period of 24 months who were affected by mechanical restraint, seclusion, or compulsory medication. In addition to the patterns of coercive measures, we investigated the effect of each hospital on the frequency of compulsory medication and the cumulative duration of mechanical restraint and seclusion, using multivariate binary logistic regression. To compare the two outcomes between hospitals, odds ratios (OR) with corresponding 95% confidence intervals (CI) were calculated.
resultsAltogether, coercive measures were applied in 1542 cases, corresponding to an overall prevalence of 8%. The frequency and patterns of the modalities of coercive measures were different between hospitals, and the differences could be at least partially related to institutional characteristics. For the two hospitals that had no permanently locked wards, certain findings were particularly noticeable. In one of these hospitals, the probability of receiving compulsory medication was significantly higher compared with the other institutions (OR 1.9, CI 1.1-3.0 for patients < 65 years; OR 8.0, CI 3.1-20.7 for patients ≥65 years); in the other hospital, in patients younger than 65 years, the cumulative duration of restraint and seclusion was significantly longer compared with the other institutions (OR 2.6, CI 1.7-3.9).
conclusionsThe findings are compatible with the hypothesis that more open settings are associated with a more extensive use of coercion. However, due to numerous influencing factors, these results should be interpreted with caution. In view of the relevance of this issue, further research is needed for a deeper understanding of the reasons underlying the differences among hospitals.
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