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 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.

AN ANALYSIS OF COPING STRATEGY FOR NURSE CARE IN FACING PSYCHIATRIC PATIENTS IN INTENSIVE SERVICE UNITS (UPI) AT PSYCHIATRIC HOSPITAL OF DR. SOEROJO MAGELANG

2020 ◽  
Vol 2 (1) ◽  
pp. 44-48
Author(s):  
Isti Noviana ◽  
Sri Respati Andamari
Keyword(s):  
Qualitative Research ◽  
Coping Strategies ◽  
Psychiatric Hospital ◽  
Coping Strategy ◽  
Psychiatric Patients ◽  
Psychiatric Nurses ◽  
Purposive Sampling ◽  
Nurse Care ◽  
Service Unit ◽  
Natural Objects

This study aims to get understanding on how the anxiety coping strategies of psychiatric nurses in handling patients who still feel anxious in the Intensive Service Unit (UPI). The method used in this study is a qualitative research by taking data based on the condition of natural objects. The study is conducted on psychiatric nurses in the Intensive Service Unit at Prof. Dr. Soerojo psychiatric Hospital in Magelang. The respondents of this study are taken from stratified purposive sampling that the writers take 2 female psychiatric nurses from female UPI and 3 male psychiatric nurses from Male UPI. Data are collected by observation and interview. The results show that the coping strategies that emerged from each subject differr one another, not all aspects of the coping strategy were used by the respondents. This means that by varying the coping strategies emerging from each respondent can be used as a reference as a study learned by individuals with the same conditions experienced by the respondents.

scholarly journals Coercive Measures and Stigmatization in the Psychiatric Medical Care

2020 ◽  
Vol 11 (3sup1) ◽  
pp. 137-145
Author(s):  
Petronela Nechita ◽  
◽  
Liliana Luca ◽  
Alina-Ioana Voinea ◽  
Codrina Moraru ◽  
...  
Keyword(s):  
Mental Health ◽  
Psychiatric Disorders ◽  
Psychiatric Hospital ◽  
Treatment Compliance ◽  
Mental Illnesses ◽  
Internal Conflict ◽  
Involuntary Admission ◽  
Coercive Measures ◽  
Self Harm ◽  
The Law

The involuntary commitment of psychiatric patients has been done for almost a decade under the Law 487/2002, the law of mental health and protection for people with psychiatric disorders. Frequent involuntary psychiatric hospitalizations have led to stigma attitudes and discriminatory acts towards patients with mental disorders. The coercive medical measures are applied in the psychiatric institutions of the mental health protection agencies. Coercion gives rise to serious ethical debates in the psychiatric assistance. The individual who was hospitalized in a psychiatric hospital anticipates social rejection becoming defensive, withdraws socially, experiences a complex internal conflict. The goal for this study is to illustrate aspects linked to coercive measures, mechanical restraint at involuntary admission of patients with mental illnesses in the psychiatric medical assistance. Material and method: This study is a retrospective one, and the data was taken from the charts with involuntary admissions during the period of October 2002 to July 2012. The studied lot was comprised of 202 patients admitted involuntarily in a psychiatric hospital according to the Law 487/2002, the law of mental health and protection for people with psychiatric disorders. Results: Of the 25.7% patients admitted involuntarily, that required coercive measures during admission, 58% were contained for symptoms like self-harm. The mechanical contention measures were especially necessary in the acute cases with symptoms as self-harm and/or harm of others, but also in situations with hallucinatory-delirium symptoms. The ratio of male sex subjects was significantly higher in the subject lot that needed coercive measures during hospitalization, of those admitted involuntarily (86.5% vs. 72%) (p = 0.036). Conclusions: Involuntary admission and mandatory treatment remains in psychiatry a medical, legal and ethical problem. The required measures can lead mainly to clinical benefits, implying a paternal attitude from the psychiatry specialists by defying the patients’ autonomy. Treatment compliance is directly proportional to the overall level of functioning and inversely proportional to the level of self-stigmatization.

scholarly journals Admission experiences of psychiatric patients in tertiary care: An implication toward Mental Health Care Bill, 2013

2017 ◽  
Vol 08 (01) ◽  
pp. 089-095 ◽  
Author(s):  
Vijayalakshmi Poreddi ◽  
Rajalakshmi Ramu ◽  
Sugavana Selvi ◽  
Sailaxmi Gandhi ◽  
Lalitha Krishnasamy ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Psychiatric Hospital ◽  
Psychotic Disorders ◽  
Psychiatric Patients ◽  
Care Center ◽  
Tertiary Care ◽  
Perceived Coercion ◽  
Negative Pressures

ABSTRACT Background: Coercion is not uncommon phenomenon among mental health service users during their admission into psychiatric hospital. Research on perceived coercion of psychiatric patients is limited from India. Aim: To investigate perceived coercion of psychiatric patients during admission into a tertiary care psychiatric hospital. Materials and Methods: This was a cross-sectional descriptive survey carried out among randomly selected psychiatric patients (n = 205) at a tertiary care center. Data were collected through face-to-face interviews using structured questionnaire. Results: Our findings revealed that participants experienced low levels of coercion during their admission process. However, a majority of the participants were threatened with commitment (71.7%) as well as they were sad (67.8%), unpleased (69.7%), confused (73.2%), and frightened (71.2%) with regard to hospitalization into a psychiatric hospital. In addition, the participants expressed higher levels of negative pressures (mean ± standard deviation, 3.76 ± 2.12). Participants those were admitted involuntarily (P > 0.001), diagnosed to be having psychotic disorders (P > 0.003), and unmarried (P > 0.04) perceived higher levels of coercion. Conclusion: The present study showed that more formal coercion was experienced by the patients those got admitted involuntarily. On the contrary, participants with voluntary admission encountered informal coercion (negative pressures). There is an urgent need to modify the Mental Health Care (MHC) Bill so that treatment of persons with mental illness is facilitated. Family member plays an important role in providing MHC; hence, they need to be empowered.

Exposure, Relaxation, and Rescripting Therapy for Trauma-Related Nightmares With Psychiatric Inpatients: A Case Series

2020 ◽  
Vol 20 (1) ◽  
pp. 3-21
Author(s):  
Helen Reiter ◽  
Leanne Humphreys
Keyword(s):  
Acute Care ◽  
Psychiatric Hospital ◽  
Psychological Symptoms ◽  
Psychiatric Patients ◽  
Hospital Setting ◽  
Case Series ◽  
Psychiatric Inpatients ◽  
Empirically Supported ◽  
Individualized Care

Research has shown that posttraumatic stress disorder (PTSD) is a highly prevalent diagnosis for psychiatric patients, yet individualized care and treatment is limited in the inpatient acute care sector. Two case studies are presented which examine the use of Exposure, Relaxation, and Rescripting Therapy (ERRT) for chronic trauma-related nightmares, within a private acute care inpatient psychiatric hospital setting. ERRT is empirically supported with efficacy for veteran and civilian populations, however no research to date has been conducted with psychiatric inpatients. Two participants diagnosed with PTSD, suffering distressing trauma-related nightmares, completed ERRT over three sessions during their psychiatric hospital admission, with the aim of reducing the frequency and severity of nightmares and related psychological symptoms. PTSD, depression, sleep quality and quantity, and nightmare frequency and related distress, were measured pre-treatment, during treatment, and follow-up at one, 3 and 6 months. Only one participant reported ongoing nightmares by the third week of the intervention, with both participants reporting an absence of nightmares at the one and 3-month follow-ups, but mixed results by the 6-month follow-up. One participant also reported a reduction in PTSD symptoms and a mild improvement in depression. The results offer some preliminary support for the provision of ERRT for the treatment of trauma-related nightmares for psychiatric inpatients.

The Assessment of Social Breakdown in Newly-Admitted Psychiatric Patients

1975 ◽  
Vol 127 (5) ◽  
pp. 417-431 ◽  
Author(s):  
W. R. L. Clemmey ◽  
D. Kennard ◽  
B. M. Mandelbrote
Keyword(s):  
Social Class ◽  
Psychiatric Hospital ◽  
Social Group ◽  
Psychiatric Diagnosis ◽  
Quantitative Assessment ◽  
Psychiatric Patients ◽  
Level Of Functioning ◽  
Social Breakdown ◽  
The Social ◽  
The Family

SummaryThis paper presents a study of patients' social and domestic functioning preceding admission to a psychiatric hospital. A method is described for the quantitative assessment of ‘social breakdown’ in the areas of work, domestic performance and social group activity, based on reports from the patient and from another household member. Complementary changes in the domestic tasks carried out by other family members are also investigated. The sample consisted of 28 women and 17 men. Their usual level of functioning and their degree of breakdown are related to psychiatric diagnosis on admission, to the patient's position within the family and to the social class of the household. Discrepancies between reports are also investigated in relation to these variables.

Educational and Diagnostic Mmpi Characteristics of a Private Hospital Population

1971 ◽  
Vol 28 (3) ◽  
pp. 724-726
Author(s):  
Donna M. Blum
Keyword(s):  
Psychiatric Hospital ◽  
Private Hospital ◽  
Psychiatric Patients ◽  
Hospital Patients ◽  
Educational Groups ◽  
Male Patients ◽  
Hospital Population ◽  
Standard Deviations ◽  
The Individual ◽  
Personality Patterns

Little data have been published on the educational and diagnostic differences of private hospital psychiatric patients on the MMPI. The present study reports the distributions of MMPI T scores and standard deviations for 4 female and 5 male educational groups and for 3 diagnostic groups of both sexes within a randomly selected group of 363 female and 542 male patients in a private psychiatric hospital. Results suggest that MMPI personality patterns should not be considered independently of the individual testee but that private psychiatric hospital patients do not produce MMPI profiles significantly different from those in state or provincial institutions.

scholarly journals Variables Associated With the Subjective Experience of Coercive Measures in Psychiatric Inpatients: A Systematic Review

2017 ◽  
Vol 63 (2) ◽  
pp. 129-144 ◽  
Author(s):  
Carlos Aguilera-Serrano ◽  
Jose Guzman-Parra ◽  
Juan A Garcia-Sanchez ◽  
Berta Moreno-Küstner ◽  
Fermin Mayoral-Cleries
Keyword(s):  
Systematic Review ◽  
Subjective Experience ◽  
Total Sample ◽  
Emotional Impact ◽  
Staff Support ◽  
Coercive Measures ◽  
Mechanical Restraint ◽  
Study Designs

Objective: This systematic review presents evidence regarding factors that may influence the patient’s subjective experience of an episode of mechanical restraint, seclusion, or forced administration of medication. Method: Two authors searched CINAHL, PubMed, SCOPUS, Web of Science, and Psych-Info, considering published studies between 1 January 1992 and 1 February 2016. Based on the inclusion criteria and methodological quality, 34 studies were selected, reporting a total sample of 1,869 participants. Results: The results showed that the provision of information, contact and interaction with staff, and adequate communication with professionals are factors that influence the subjective experience of these measures. Humane treatment, respect, and staff support are also associated with a better experience, and debriefing is an important procedure/technique to reduce the emotional impact of these measures. Likewise, the quality of the working and physical environment and some individual and treatment variables were related to the experience of these measures. There are different results in relation to the most frequently associated experiences and, despite some data that indicate positive experiences, the evidence shows such experiences to be predominantly negative and frequently with adverse consequences. It seems that patients find forced medication and seclusion to be more tolerable than mechanical restraint and combined measures. Conclusions: It appears that the role of the staff and the environmental conditions, which are potentially modifiable, affect the subjective experience of these measures. There was considerable heterogeneity among studies in terms of coercive measures experienced by participants and study designs.

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