Nataliya Konstantinovna Rzhevskaya
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Viktor Aleksandrovich Ruzhenkov
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Nazim Yasharovich Orudzhev
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Oleg Yurievich Shiryaev
In accordance with international principles for the protection of persons with mental disorders, physical restraint and isolation of the patient are used only in compliance with the approved regulations of the psychiatric hospital in cases where this is the only available way to prevent direct harm to the patient or other persons. Nevertheless, in real practice, there are often cases of applying measures of physical restraint, feeding and administering drugs against the will of the patient. The attitude of psychiatrists of psychiatric hospitals of the Belgorod, Volgograd and Voronezh Regions to coercion and violence in the provision of psychiatric care was studied. It was found that the majority of psychiatrists (91.6%) consider coercion of people with mental disorders to be justified, and 60% delegate this right to nurses. More than 90% of psychiatrists consider justified the use of physical restraint to a patient admitted to hospital treatment on a voluntary basis, in the case of psychomotor agitation with heteroagression, and 20% allow their personal participation in its implementation. Almost 47% of psychiatrists allow other patients to be involved in a forced injection to a patient who refuses therapy. The majority of psychiatrists (71%) consider it common practice to force patients with mental disorders who tend to “lie in bed” to clean the ward, department, hospital grounds, regarding it as “rehabilitation” and “labor therapy”. To prevent the use of violence and coercion in a psychiatric hospital, a transition from the paternalistic to the contractual model of psychiatric care is necessary. It is important to develop standards for the provision of psychiatric care in involuntary hospitalization, taking into account the compliance, and also to increase the legal competence of psychiatrists.
Physical Restraint in Psychiatric Care: Soon to Fall Out of Use?
