[The use of mechanical restraint and seclusion: comparing the clinical practice in Germany and Switzerland].
OBJECTIVE
Although coercive measures are one of the indicators of the quality of psychiatric in-patient care, reliable and valid data comparing the practice in different countries are not available. Due to the diversity of definitions, types of coercive measures analysed, case/patient mix and indicators calculated, published national results can not be compared. This study intended to standardizedly assess the use of mechanical restraint and seclusion across German and Swiss hospitals.


METHODS
The frequency and duration of these coercive measures among patients with ICD-10 F1, F2, F3, F4 and F6 disorders was analysed in seven German and seven Swiss psychiatric hospitals in the year 2004.


RESULTS
In Swiss hospitals more cases were exposed to seclusion. In German hospitals more cases were exposed to mechanical restraint. Seclusion as well as mechanical restraint per case were applied more often in German hospitals. Seclusion as well as mechanical restraint were of longer duration in Swiss hospitals.


CONCLUSIONS
The results showed different patterns in the use of seclusion and mechanical restraint across Swiss and German hospitals. For future European research, there is a need for uniformed definitions, and reliable documentation of coercive measures and for an identical method of data analysis.
Martin
Veronika
V
Zentrum für Psychiatrie Die Weissenau, Abteilung Psychiatrie I der Universität Ulm, Weingartshofer Strasse 2, 88214 Ravensburg-Weissenau.
Bernhardsgrütter
Renate
R
Göbel
Rita
R
Steinert
Tilman
T
D003431:Cross-Cultural Comparison; D003953:Diagnosis-Related Groups; D004282:Documentation; D005858:Germany; D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology* / Q000628:therapy; D010343:Patient Admission / Q000706:statistics & numerical data*; D010356:Patient Isolation / Q000706:statistics & numerical data*; D019984:Quality Indicators, Health Care; D012149:Restraint, Physical / Q000706:statistics & numerical data*; D013557:Switzerland; D014600:Utilization Review / Q000706:statistics & numerical data