Patients’ and Family Attitudes Toward Seclusion and Restraint

Abstract

Background and aim:

Coercive physical measures, such as seclusion and restraint are sometimes used in psychiatric inpatient treatment for the management of severely disturbed behaviour of patients. As part of a larger study on the use of restraint and seclusion in a psychiatric unit of a general hospital in Greece we aimed to record the patients’ and their relatives’ attitudes on coercive measures.

Methods:

Data regarding patients’ and family accounts on coercive measures were collected retrospectively with chart review of all patients who had been admitted to the psychiatric ward of the University Hospital of Ioannina over a six-month period and had been subjected to restraint or seclusion. During hospitalization and after the periods of restraint or seclusion, patients and relatives had been asked whether they considered coercion as justified or not. Patients had been also asked whether they perceived this experience as harmful.

Results:

Thirty one cases of restraint and seclusion from a total of 282 admissions were recorded during the study period. In 6 cases the patients refused to answer or did not have the decision making capacity. Twenty out of 25 (80%) patients considered their coercion to be unjustified and perceived it as traumatic experience. Twenty-five out of 28 (89.3%) relatives considered justified the decision to restrain or seclude the patient.

Conclusions:

Patients and their families have different accounts on coercion, but more research is needed. It is important for care planning to record the patients’ and families’ views and integrate them in mental health policy making.