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Tijdschrift voor Psychiatrie 58 (2016) 6, 434 - 445

New research

A study of the connection between coercive measures used in a closed acute psychiatric ward and the socio-demographic and clinical characteristics of the patients involved

N. Miedema, M.C. Hazewinkel, D. van Hoeken, A.S van Amerongen, R.F.P. de Winter

background Admission at a closed acute psychiatric ward is a severe and possibly life changing experience for a patient. Sometimes admission is accompanied by coercive measures. Despite the impact that these measures may have on the patient, very little research has been published concerning this patient population.
aim To obtain insight into the connection between the socio-demographic characteristics of patients admitted to a closed acute psychiatric ward and the coercive measures to which they were subjected.
method For a year a database was compiled to give us information about the socio-demographic and clinical characteristics of patients admitted to a closed acute psychiatric ward in The Hague in the Netherlands. This record enables us to analyse the relation between these characteristics and coercive measures.
results The majority of patients admitted were male, single, childless and were unemployed or not in education but were receiving some form of welfare payment. 33% of admissions were in fact re-admissions. 20% of the admissions/re-admissions were secluded during the admission procedure – for the following reasons: symptoms of a psychotic disorder, a manic episode and/or aggression. Secluded patients were younger and had more serious psychiatric problems; they functioned less well and had been in hospital longer than patients who had not been secluded upon admission. During the admission procedure 14% of patients received emergency medication.
conclusion These results have given us more insight into the connection between the use of coercive measures in psychiatry and the socio-demographic characteristics and clinical characteristics of the patients involved. This information could serve as reference material for future research.

keywords acute psychiatry, closed ward, severe mental illness, coercive methods, seclusion, emergency medication