Evidence map›Paper›PMID 35222103›Full record

ArticleFrontiers in psychiatry2021

The Compulsory Care Act: Early Observations and Expectations of In- or Outpatient Involuntary Treatment.

Stephan Gemsa, Eric O Noorthoorn, Peter Lepping, Hein A de Haan, Andre I Wierdsma, Giel J M Hutschemaekers

Abstract read
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Article in Frontiers in psychiatry, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Stephan GemsaGgnet Mental Health Institute, Child Psychiatry Service, Warnsveld, Netherlands.
Eric O NoorthoornGgnet Mental Health Institute, Child Psychiatry Service, Warnsveld, Netherlands.
Peter LeppingBetsi Cadwaladr University Health Board, Wrexham, United Kingdom.
Hein A de HaanGgnet Mental Health Institute, Child Psychiatry Service, Warnsveld, Netherlands.
Andre I WierdsmaDepartment of Psychiatry, Erasmus Medical Centre, Rotterdam, Netherlands.
Giel J M HutschemaekersBehavioral Science Institute, University of Nijmegen, Nijmegen, Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOn January 1, 2020, the Dutch Compulsory Care Act (WvGGZ) replaced the Special Admissions Act (BOPZ). While the old law only allowed compulsory treatment in hospitals, the new law allows it both inside and outside the hospital. Moreover, the new law prioritizes the patient's own opinion on coercive measures. By following patients' own choices, the Compulsory Care Act is hoped to lead to fewer admission days and less inpatient compulsory treatment in involuntarily admitted patients.

methodsWe studied the seclusion and enforced-medication events before and after January 1, 2020, using coercive measures monitoring data in a Mental Health Trust. Trends in hours of seclusion and the number of enforced-medication events per month from 2012 to 2019 were compared with 2020. We used generalized linear models to perform time series analysis. Logistic regression analyses and generalized linear models were performed to investigate whether patient compilation determined some of the observed changes in seclusion use or enforced-medication events.

resultsThe mean number of hours of seclusion between 2012 and 2019 was 27,124 per year, decreasing from 48,542 in 2012 to 21,133 in 2019 to 3,844 h in 2020. The mean incidence of enforced-medication events between 2012 and 2019 was 167, increasing from 90 in 2012 to 361 in 2019 and then fell to 294 in 2020. In 2020, we observed 3,844 h of seclusion and 294 enforced-medication events. Near to no outpatient coercion was reported, even though it was warranted. The time series analysis showed a significant effect of the year 2020 on seclusion hours (β = -1.867; Exp(β) = 0.155, Wald = 27.22, p = 0.001), but not on enforced-medication events [β = 0.48; Exp(β) = 1.616, Wald = 2.33, DISCUSSION: There was a reduction in the number of seclusion hours after the introduction of the Compulsory Care Act. The number of enforced-medication events also increased from a very low baseline, but from 2017 onwards. To see whether these findings are consistent over time, they need to be replicated in the near future.

conclusionWe observed a significant increase in enforced-medication use and a decrease in seclusion hours. The year 2020 predicted seclusion hours, but not enforced-medication events.

Indexed as

coercioncommunity treatment ordercompulsory care actenforced medicationinvoluntary inpatient treatmentinvoluntary outpatient treatmentseclusion

Identifiers

PMID35222103
PMCPMC8864544

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