scholarly journals Variables Associated with the Use of Coercive Measures on Psychiatric Patients in Spanish Penitentiary Centers

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
E. Girela ◽  
A. López ◽  
L. Ortega ◽  
J. De-Juan ◽  
F. Ruiz ◽  
...  
Keyword(s):  
Mentally Ill ◽  
Psychiatric Patients ◽  
Psychiatric Inpatient ◽  
Psychiatric Hospitals ◽  
Coercive Measure ◽  
Coercive Measures ◽  
External Assessment ◽  
Mechanical Restraint ◽  
The Family ◽  
Inpatient Units

We have studied the use of coercive medical measures (forced medication, isolation, and mechanical restraint) in mentally ill inmates within two secure psychiatric hospitals (SPH) and three regular prisons (RP) in Spain. Variables related to adopted coercive measures were analyzed, such as type of measure, causes of indication, opinion of patient inmate, opinion of medical staff, and more frequent morbidity. A total of 209 patients (108 from SPH and 101 from RP) were studied. Isolation (41.35%) was the most frequent coercive measure, followed by mechanical restraint (33.17%) and forced medication (25.48%). The type of center has some influence; specifically in RP there is less risk of isolation and restraint than in SPH. Not having had any previous imprisonment reduces isolation and restraint risk while increases the risk of forced medication, as well as previous admissions to psychiatric inpatient units does. Finally, the fact of having lived with a partner before imprisonment reduces the risk of forced medication and communication with the family decreases the risk of isolation. Patients subjected to a coercive measure exhibited a pronounced psychopathology and most of them had been subjected to such measures on previous occasions. The mere fact of external assessment of compliance with human rights slows down the incidence of coercive measures.

scholarly journals A Study on the Problems faced by Mentally ill Patients living in Mangalore

2017 ◽  
pp. 24-30
Author(s):  
Meena Monteiro ◽  
Laveena D’Mello
Keyword(s):  
Physical Health ◽  
Health Problem ◽  
Mentally Ill ◽  
Psychiatric Patients ◽  
Family Members ◽  
Secondary Data ◽  
Lifestyle Factors ◽  
Physical And Mental Health ◽  
The Family ◽  
Obesity Hypertension

Psychiatric patients have got an increased morbidity and mortality to other physical health problem. The most problem they are facing is the lifestyle factors such as the use of substances and the decreased physical activity. These patients are mainly restricted to their home. If mental ill patients do not create any problems to the family members and their neighbouring families, the family members are happy and not so much bother about the patients. And if they are not creating any problems for others, family members are not bothered or motivated to treat the mentally ill patients. Hence the lack of motivation from the other family members results in mentally ill patients showing the symptoms of the high risk of being affected by other health problem. There is the availability of treatment to the mentally ill patient. There was only a little availability of the treatment facilities for the psychiatric patients. So the lack of services available and the most vulnerable nature made them more adherent to the problems. There is a direct relationship between the physical and mental health of the patients. In this study the researcher dealing with only the minor issues such as substance abuse, obesity, hypertension, diabetes along with the mental illness, and it would be a way to understand the problems of these patients. The main aim of the study is to study the problems of mentally ill patients and the objectives are; to study the physical health status of the mentally ill patients; and to study the lifestyle factors such as smoking and alcoholism affected the life of mentally ill. The detail studies of 5o intake patients from the hospital where the psychiatric department exist are taken. The interview schedule is used and more observation and case records were referred to get the history. Secondary data is also considered for the research study.

Can we reduce the need for coercive interventions?

2017 ◽  
Author(s):  
George Szmukler
Keyword(s):  
Complex Interventions ◽  
Psychiatric Hospitals ◽  
The United States ◽  
Treatment Preferences ◽  
Controlled Trials ◽  
Treatment Team ◽  
Crisis Plans ◽  
Coercive Measures ◽  
Randomized Controlled ◽  
Inpatient Units

Sadly, little research has been devoted to developing interventions aimed at reducing the use of coercive measures. A large study in the United States showed that patient perceptions of coercion at admission to psychiatric hospitals are less if they believe their ‘voice’ has been heard, and they have been treated with respect, concern, and in good faith—termed ‘procedural justice’. However, trials of whether training staff in accord with these observations will reduce coercion have yet to be done. The most promising interventions to reduce involuntary admissions have been ‘joint crisis plans’. These offer opportunities for patients to state their treatment preferences in case of future crises, and plans are negotiated in joint meetings with the treatment team. Though randomized controlled trials are lacking, ‘before versus after’ comparisons have suggested a range of complex interventions that may reduce the use of coercive measures, such as restraint and seclusion, on inpatient units.

scholarly journals Commentary: seclusion and mechanical restraint of psychiatric patients in Israel - an update

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Yoav Kohn ◽  
Igor Barash ◽  
Gadi Lubin
Keyword(s):  
Health Policy ◽  
Psychiatric Hospital ◽  
Psychiatric Patients ◽  
Current Situation ◽  
Antipsychotic Medications ◽  
Coercive Measures ◽  
Mechanical Restraint ◽  
Inpatient Ward ◽  
Official Policy ◽  
Retrospective Examination

Abstract Recently, Miodownik et al. reported in this journal the results of a study on seclusion and mechanical restraint of psychiatric patients in Israel (Isr J Health Policy Res 8:9, 2019). The study was a retrospective examination over a year of one inpatient ward in a psychiatric hospital. They found negative associations between length of use of coercive measures and the diagnosis of schizophrenia, being single, and the presence of academic nurses. Positive associations were found between length of use of coercive measures and the use of antipsychotic medications, violence towards oneself, and the use of restraint compared to seclusion. Interesting and important as they are, these results were obtained from data gathered in 2014. As the authors note, since then there has been a dramatic change in the official policy of the Israeli Ministry of Health on this topic and in the practice of seclusion and mechanical restraint in Israel. This commentary reviews and comments on the current situation.

scholarly journals Psychiatric Patients Experiences with Mechanical Restraints: An Interview Study

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Klas Lanthén ◽  
Mikael Rask ◽  
Charlotta Sunnqvist
Keyword(s):  
Psychiatric Patients ◽  
Psychiatric Nurses ◽  
Qualitative Design ◽  
Mechanical Restraint ◽  
Inductive Approach ◽  
The World ◽  
Physical Presence ◽  
Patients Experience ◽  
Mechanical Restraints ◽  
Inpatient Units

Objective. To examine psychiatric patients’ experience of mechanical restraints and to describe the care the patients received.Background. All around the world, threats and violence perpetrated by patients in psychiatric emergency inpatient units are quite common and are a prevalent factor concerning the application of mechanical restraints, although psychiatric patients’ experiences of mechanical restraints are still moderately unknown.Method. A qualitative design with an inductive approach were used, based on interviews with patients who once been in restraints.Results. This study resulted in an overbridging theme:Physical Presence, Instruction and Composed Behaviour Can Reduce Discontent and Trauma, including five categories. These findings implicated the following: information must be given in a calm and sensitive way, staff must be physically present during the whole procedure, and debriefing after the incident must be conducted.Conclusions. When mechanical restraints were unavoidable, the presence of committed staff during mechanical restraint was important, demonstrating the significance of training acute psychiatric nurses correctly so that their presence is meaningful. Nurses in acute psychiatric settings should be required to be genuinely committed, aware of their actions, and fully present in coercive situations where patients are vulnerable.

Per una storia dell'affidamento dei malati psichiatrici alle famiglie: Towards a history of the family care of psychiatric patients

2009 ◽  
Vol 18 (1) ◽  
pp. 34-39 ◽  
Author(s):  
Patrizia Guarnieri
Keyword(s):  
Mental Health ◽  
Mentally Ill ◽  
Psychiatric Patients ◽  
Family Care ◽  
Special Role ◽  
The Past ◽  
The Family ◽  
History Of ◽  
Psychiatric Staff

SummaryInserting adults with psychic problems into families has recently been practiced in various European countries and also in Italy, where some mental health departments support such families. Beyond the well known story of Gheel, the etero and omofamily care of psychiatric patients has a forgotten history. Methods – On the basis of unexplored and exceptionally rich sources from the archives of the asylums in Florence, as well as of the Province di Florence, which funded assistance to the mentally ill – this research focuses on the subsidized “domestic custody” of hundreds of psychiatric patients, who had already been institutionalized. Beginning in 1866, outboarding was supported by the provincial administration in Florence with the collaboration of the asylum medical direction. Results – In the late 19th C. and in the early 20th C. prestigious psychiatrists sought alternatives to the institutionalisation. These alternatives involved varied participants in a community (the patients and their families, the administrators and the medical specialists, the neighborhood and the police). The families played a special role that historians of the psychiatry exclusively dedicated to the insane asylums have not really seen. Conclusions – The role of the families in the interaction with the psychiatric staff is not, even on a historiographical level, simply an additional and marginal chapter of the practices and of the culture of the mental health. These archival evidence contradicts some common places on the past of the Italian psychiatry before 1978, and provokes new reflections of possible relevance to the present.

Prevalence and Precipitants of Aggression in Psychiatric Inpatient Units

2000 ◽  
Vol 34 (6) ◽  
pp. 967-974 ◽  
Author(s):  
Karen Barlow ◽  
Brin Grenyer ◽  
Olga Ilkiw-Lavalle
Keyword(s):  
Psychiatric Patients ◽  
Bipolar Affective Disorder ◽  
Psychiatric Inpatient ◽  
Management Strategies ◽  
Adjustment Disorder ◽  
Clinical Problem ◽  
Causal Factors ◽  
Increased Risk ◽  
Psychiatric Units ◽  
Inpatient Units

Objective: Aggression is a significant clinical problem in psychiatric facilities. The present study reviews data on aggression collected from psychiatric inpatient units in order to determine prevalence and causal factors. Method: Data on aggressive incidents were gathered from four adult psychiatric units in the Illawarra, Australia. Information obtained included diagnosis, causal factors and patient sociodemographic characteristics. Results: During the 18-month period, a total of 1269 psychiatric patients were admitted and 174 patients (13.7%) were recorded as being aggressive. Patients with bipolar affective disorder and schizophrenia had a 2.81 and 1.96 significantly increased risk of aggression, respectively, while depression and adjustment disorder conferred a significantly lower risk. Aggression was most likely to occur within 2 days of admission and length of stay was greater for aggressive than non-aggressive patients. The greater number of incidents occurred on day shift. Most patients who displayed aggression did so on one occasion, but a small proportion of total patients (6.0%) accounted for a large number of incidents (71.0%). High-risk patients were identified as those who were under 32 years of age, were actively psychotic, detained and known to have a history of aggression and substance misuse. The most frequent form of aggression was physical and staff were most often the victims. Conclusions: These results have important implications for predicting and thereby reducing inpatient aggression. Organisations need to ensure aggression management strategies are in place and periodically identify and assess the level of risk for workers.

scholarly journals Methods and Strategies for Reducing Seclusion and Restraint in Child and Adolescent Psychiatric Inpatient Care

2021 ◽  
Author(s):  
Charlotta Perers ◽  
Beata Bäckström ◽  
Björn Axel Johansson ◽  
Olof Rask
Keyword(s):  
Dialectical Behavior Therapy ◽  
Care Pathway ◽  
Psychiatric Inpatient ◽  
Child And Adolescent ◽  
Autism Spectrum ◽  
Successful Implementation ◽  
Negative Consequences ◽  
Coercive Measures ◽  
Trauma Informed ◽  
Inpatient Units

AbstractRestraints and seclusions are restrictive interventions used in psychiatric inpatient units when there is an imminent risk of harm to the patient or others. Coercive measures are controversial and can lead to negative consequences, including negative emotions, re-traumatization, injuries, or death. The article summarizes the last 10 years of literature regarding methods and strategies used for reducing seclusions and restraints in child and adolescent psychiatric inpatient units, and reports on their outcomes. The literature was reviewed by searching PubMed and PsycInfo for English-language articles published between May 2010 and May 2020. Eighteen articles were found that described methods or strategies aimed at reducing restraint or seclusion utilization in child and adolescent psychiatric inpatient units. The following interventions were evaluated: Trauma-Informed Care (TIC), Six Core Strategies, Child and Family Centered Care (CFCC), Collaborative & Proactive Solutions (CPS), Strength-Based Care, Modified Positive Behavioral Interventions and Supports (M-PBIS), Behavioral Modification Program (BMP), Autism Spectrum Disorder Care Pathway (ASD-CP), Dialectical Behavior Therapy (DBT), sensory rooms, Mindfulness-Based Stress Reduction Training (MBSR) of staff, and Milieu Nurse-Client Shift Assignments. Most of the interventions reduced the use of seclusions and/or restraints. Two child-centered and trauma-informed initiatives eliminated the use of mechanical restraints. This review shows that the use of coercive measures can be reduced and should be prioritized. Successful implementation requires ongoing commitment on all levels of an organization and a willingness to learn. To facilitate comparisons, future models should evaluate different standardized parameters.

scholarly journals Admitting Mentally Ill Mothers with their Babies into Psychiatric Hospitals

1986 ◽  
Vol 10 (7) ◽  
pp. 169-172 ◽  
Author(s):  
R. Kumar ◽  
E. S. Meltzer ◽  
Rosalind Hepplewhite ◽  
A. D. Stevenson
Keyword(s):  
Adverse Effects ◽  
Mental Disorder ◽  
Mentally Ill ◽  
Clinical Management ◽  
Family Background ◽  
Psychiatric Hospitals ◽  
Psychological Development ◽  
The Other ◽  
Other Hand ◽  
The Family

The clinical management of a mother who has a severe puerperal mental disorder is complicated by the fact that her baby is not ill and does not need to be in hospital—especially a psychiatric one. On the other hand, separating babies from their mothers can have adverse effects upon their relationship and upon the psychological development of the infant, although much depends upon the timing, nature and duration of the separation as well as on the quality and stability of the family background.

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