ArticleThe Lancet regional health. Europe2021
Effect of the introduction of immediate judge's decisions in 2018 on the use of coercive measures in psychiatric hospitals in Germany: a population-based study.
Article in The Lancet regional health. Europe, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 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.
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Who cites it
9 citing papers in PubMed, 2 syntheses or guidelines 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
- Variations in definitions used for describing restrictive care practices (seclusion and restraint) in adult mental health inpatient units: a systematic review and content analysis.Social psychiatry and psychiatric epidemiology · 2025Pooled it
- Impact of legislative reform on coercive measure use in child and adolescent psychiatry: A controlled interrupted time series analysis.European child & adolescent psychiatry · 2026Article
- Article
- 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
- Effects of stricter legislation on coercive measures in child and adolescent psychiatric care: a qualitative interview study with staff.BMC psychiatry · 2024Article
- Implementation of guidelines on prevention of coercion and violence (PreVCo) in psychiatry: a multicentre randomised controlled trial.The Lancet regional health. Europe · 2023Article
- Estimating costs of bedside assessment by a judge in each case of mechanical restraint in Germany after new legislation.Frontiers in psychiatry · 2023Article
- Increase in coercive measures in psychiatric hospitals in Germany during the COVID-19 pandemic.PloS one · 2022Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOn 23 July 2018, the German Constitutional Court decided that mechanical restraint in psychiatric patients lasting longer than 30 minutes requires a judge's immediate decision. On the same day, the German Association for Psychiatry and Psychotherapy published its guideline on the prevention of coercion and violence. The registry for coercive measures in the federal state of Baden-Wuerttemberg, available since 2015 and comprising all 32 hospitals licensed to admit involuntary patients, has made it possible to evaluate the effect of the legal change, considered the strongest intervention ever in Germany to reduce coercion.
methodsWe analysed the mean percentage of patients subjected to coercive measures and the mean cumulative duration of these interventions in ICD-10 diagnostic groups in psychiatric hospitals from 2017 compared to 2019 among a total of 233,0273 admissions.
findingsThe percentage of patients subjected to any kind of freedom-restricting coercion decreased from 6·6% in 2017 to 5·8% in 2019 (p = 0·000). Accordingly, the percentage of patients subjected to mechanical restraint decreased from 4·8% to 3·6% in 2019 (p = 0·000). At the same time, the percentage of patients subjected to seclusion increased from 2·9% to 3·3% (p = 0·000). The median cumulated duration of restraint and seclusion per affected case decreased from 12·5 to 11·9 hrs (p = 0·001).
interpretationThere is clear evidence that a strong legal intervention was effective in reducing the use of coercive measures under routine conditions
fundingThe registry is funded by the Ministry of Social Welfare and Integration.
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