title: The use of coercive measures in adolescent psychiatric inpatient treatment: a nation-wide register study.
abstract: OBJECTIVE
  To evaluate the extent and trends in the use of seclusion/restraint in psychiatric inpatient treatment of adolescents aged 12-17 years in Finland.
  
  
  METHODS
  The National Hospital Discharge Register data comprising all psychiatric inpatient treatment periods of 12- to 17 year-olds in Finland during the period 1996-2003 was used. Time trends, regional variation and patient characteristics related to the risk of being subjected to seclusion/restraint in psychiatric inpatient treatment are reported.
  
  
  RESULTS
  The average prevalence of use of seclusion and restraint was 1.71/10,000/year over the study period. Use of seclusion/restraint in adolescent psychiatric inpatient care first increased, peaking in 1999-2001, and then decreased. The decrease occurred after stricter legislative control of use of seclusion/restraint was introduced in 2002, despite that involuntary treatment periods did not decrease. Considerable regional variation was seen in the use of seclusion/restraint. A greater proportion of girls than boys were secluded/restrained. Seclusion/restraint was most common in schizophrenia, mood disorders and conduct disorder.
  
  
  CONCLUSIONS
  Legislative control had the desired immediate impact on the use of seclusion/restraint in adolescent psychiatric inpatient care. Legislative control is, however, not strong enough to ensure homogenous practices across the country, as there is many-fold regional variation in figures for using seclusion and restraint.
authors: Department of Nursing Science, University of Turku, 20014, Turku, Finland.
authors: Siponen
authors: S
authors: Ulla
authors: Välimäki
authors: V
authors: Maritta
authors: Kaltiala-Heino
authors: KH
authors: Riittakerttu
mesh_terms: D000293:Adolescent; D000296:Adolescent Psychiatry; D002648:Child; D003068:Coercion; D005260:Female; D005387:Finland / Q000453:epidemiology; D006760:Hospitalization; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data; D006801:Humans; D007297:Inpatients / Q000523:psychology / Q000706:statistics & numerical data; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D010356:Patient Isolation / Q000706:statistics & numerical data*; D015995:Prevalence; D012042:Registries; D012149:Restraint, Physical / Q000706:statistics & numerical data*; D012306:Risk