ArticleEuropean psychiatry : the journal of the Association of European Psychiatrists2025
Relative efficiency of psychiatric clinics in treating cases without coercion and achieving symptom reduction.
Article in European psychiatry : the journal of the Association of European Psychiatrists, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Nurse Staffing in Psychiatric Inpatient Care: A Multicentre Study Using Routine Patient and Structural Data.Journal of nursing management · 2026Observational
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6 authors.
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Abstract
backgroundThe use of coercive measures is an increasingly debated aspect of psychiatric treatment. Considering the multitude of negative effects, patients, clinicians, and ethicists alike have called for a more cautious application of coercion. It therefore remains important to investigate which organizational characteristics have the potential to facilitate efficient coercion reduction. The same holds true for the efficient reduction of symptom severity during inpatient treatment.
methodsThe current study compared 22 Swiss psychiatric clinics treating 45,095 cases regarding their relative efficiency in treating cases without coercion given their staff resources. To this end, we applied a Data Envelopment Analysis to clinical routine data. We focused specifically on inefficiencies attributable to management factors independent of the clinics' total staff numbers. We further compared the clinics' relative efficiencies regarding changes of self-reports and third-person reports of symptom severity during inpatient stays.
resultsEfficiency scores suggest that on average, the clinics could improve the percentage of cases treated without coercion by 9% and the changes of symptom severity by 34% (for third-person ratings) or 18% (for self-reports) while keeping staff numbers constant. An analysis of specific coercion types revealed that the potential for efficiency improvements via management was highest for movement restrictions. We found no effect of clinic size on efficiency scores regarding any of the outcome measures.
conclusionsOur results underline the importance of management factors beyond staff resources (e.g., staff trainings or changes in ward structure and treatment concepts) for the efficient reduction of coercion and psychiatric symptoms during inpatient stays.
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