title: Use of coercive measures during involuntary hospitalization: findings from ten European countries.
abstract: OBJECTIVE
  Involuntary treatment in mental health care is a sensitive but rarely studied issue. This study was part of the European Evaluation of Coercion in Psychiatry and Harmonization of Best Clinical Practice (EUNOMIA) project. It assessed and compared the use of coercive measures in psychiatric inpatient facilities in ten European countries.
  
  
  METHODS
  The sample included 2,030 involuntarily admitted patients. Data were obtained on coercive measures (physical restraint, seclusion, and forced medication).
  
  
  RESULTS
  In total, 1,462 coercive measures were used with 770 patients (38%). The percentage of patients receiving coercive measures in each country varied between 21% and 59%. The most frequent reason for prescribing coercive measures was patient aggression against others. In eight of the countries, the most frequent measure used was forced medication, and in two of the countries mechanical restraint was the most frequent measure used. Seclusion was rarely administered and was reported in only six countries. A diagnosis of schizophrenia and more severe symptoms were associated with a higher probability of receiving coercive measures.
  
  
  CONCLUSIONS
  Coercive measures were used in a substantial group of involuntarily admitted patients across Europe. Their use appeared to depend on diagnosis and the severity of illness, but use was also heavily influenced by the individual country. Variation across countries may reflect differences in societal attitudes and clinical traditions.
authors.affiliation: Department of Psychiatry, Charles University, First Faculty of Medicine, Prague 2, Czech Republic. raboch@cesnet.cz
authors.forename: Jirí
authors.initials: J
authors.lastname: Raboch
authors.forename: Lucie
authors.initials: L
authors.lastname: Kalisová
authors.forename: Alexander
authors.initials: A
authors.lastname: Nawka
authors.forename: Eva
authors.initials: E
authors.lastname: Kitzlerová
authors.forename: Georgi
authors.initials: G
authors.lastname: Onchev
authors.forename: Anastasia
authors.initials: A
authors.lastname: Karastergiou
authors.forename: Lorenza
authors.initials: L
authors.lastname: Magliano
authors.forename: Algirdas
authors.initials: A
authors.lastname: Dembinskas
authors.forename: Andrzej
authors.initials: A
authors.lastname: Kiejna
authors.forename: Francisco
authors.initials: F
authors.lastname: Torres-Gonzales
authors.forename: Lars
authors.initials: L
authors.lastname: Kjellin
authors.forename: Stefan
authors.initials: S
authors.lastname: Priebe
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Kallert
mesh_terms: D000328:Adult; D003068:Coercion; D003134:Commitment of Persons with Psychiatric Disorders; D005060:Europe; D005260:Female; D006760:Hospitalization; D006778:Hospitals, Psychiatric; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies