ArticlePloS one2022
Increase in coercive measures in psychiatric hospitals in Germany during the COVID-19 pandemic.
Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.
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Who cites it
18 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
- Incidence of Using Physical, Mechanical Restraints and Seclusion in Saudi Mental Health Settings: A Prospective Cohort Study.Healthcare (Basel, Switzerland) · 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
- [The current legal practice of judicial review of restraints].Der Nervenarzt · 2025Article
- [Mental healthcare in South Tyrol].Der Nervenarzt · 2025Article
- Drug utilization in geriatric psychiatric patients in the emergency department-a cohort study under real-world conditions.Therapeutic advances in psychopharmacology · 2025Article
- Factors associated with seclusion and restraint on admission to forensic psychiatric hospitals: A 10-year retrospective study.PloS one · 2025Article
- Surveying Child and Adolescent Inpatient Psychiatric Units: Demographics, Policies, and Practice.Evidence-based practice in child and adolescent mental health · 2024Article
- Seclusion and mechanical restraint in the wake of the COVID-19 pandemic: an increased use in mental health settings.Frontiers in psychiatry · 2024Article
- Article
- A country report: impact of COVID-19 lockdowns on involuntary psychiatric treatment in Austria.BJPsych open · 2023Article
- Implementation of guidelines on prevention of coercion and violence (PreVCo) in psychiatry: a multicentre randomised controlled trial.The Lancet regional health. Europe · 2023Article
- Article
- 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
- Article
- Involuntary Hospitalizations in an Italian Acute Psychiatric Ward: A 6-Year Retrospective Analysis.Patient preference and adherence · 2023Article
- Analysis of the utilization, processes, and outcomes of inpatient mental healthcare during the first three waves of the COVID-19 pandemic in the federal state of North Rhine-Westphalia, Germany.Frontiers in psychiatry · 2022Article
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo examine whether the pandemic in 2020 caused changes in psychiatric hospital cases, the percentage of patients exposed to coercive interventions, and aggressive incidents.
methodsWe used the case registry for coercive measures of the State of Baden-Wuerttemberg, comprising case-related data on mechanical restraint, seclusion, physical restraint, and forced medication in each of the State's 31 licensed hospitals treating adults, to compare data from 2019 and 2020.
resultsThe number of cases in adult psychiatry decreased by 7.6% from 105,782 to 97,761. The percentage of involuntary cases increased from 12.3 to 14.1%, and the absolute number of coercive measures increased by 4.7% from 26,269 to 27,514. The percentage of cases exposed to any kind of coercive measure increased by 24.6% from 6.5 to 8.1%, and the median cumulative duration per affected case increased by 13.1% from 12.2 to 13.8 hrs, where seclusion increased more than mechanical restraint. The percentage of patients with aggressive incidents, collected in 10 hospitals, remained unchanged.
conclusionsWhile voluntary cases decreased considerably during the pandemic, involuntary cases increased slightly. However, the increased percentage of patients exposed to coercion is not only due to a decreased percentage of voluntary patients, as the duration of coercive measures per case also increased. The changes that indicate deterioration in treatment quality were probably caused by the multitude of measures to manage the pandemic. The focus of attention and internal rules as well have shifted from prevention of coercion to prevention of infection.
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