title: Mechanical restraint in adolescent psychiatry: a Finnish Register study.
abstract: BACKGROUND
  Little is known of the use of mechanical restraint in adolescent psychiatry.
  
  
  OBJECTIVE
  To investigate the frequency and features of mechanical restraint in the field of Finnish adolescent psychiatry.
  
  
  METHODS
  The data were collected in the metropolitan area of Helsinki, Finland, with seven closed and eight open wards for Finnish-speaking 13-17-year-old adolescents. The official restraint reports and the hospital files of the restraint patients from January 2009 to December 2009 were collected and analyzed.
  
  
  RESULTS
  Among adolescents hospitalized in closed wards, the 1-year prevalence of mechanical restraint was 9.5%. Among all hospitalized adolescents, the prevalence was 6.9%. The number of mechanically restrained individuals per 100,000 13 to 17-year -old Finnish-speaking inhabitants was 57.1. The median duration of the restraint episode was 4 h and 50 min, but almost half of the mechanical restraint episodes lasted 8 h or more. A quarter of restraint episodes were not based on reasons mentioned in the Finnish Mental Health Act. The most frequent diagnostic categories of mechanically restrained adolescents were mood disorders followed by schizophrenia-related as well as behavioral and emotional disorders. Suicidality preceded 40% and violence 61% of restraint episodes. Boys were restrained during the first days of hospital treatment significantly more often than were girls, whereas one in four girls experienced her first episode of restraint after 1 month of hospitalization.
  
  
  CONCLUSIONS
  Reducing the number and shortening the length of mechanical restraint episodes requires education of staff as well as projects focusing on reducing coercion. The clinical guidelines must be followed at grassroots level.
authors: Department of Nursing Science, University of Turku, Finland. aakhot@utu.fi
authors: Anja
authors: A
authors: Hottinen
authors: Maritta
authors: M
authors: Välimäki
authors: Eila
authors: E
authors: Sailas
authors: Hanna
authors: H
authors: Putkonen
authors: Grigori
authors: G
authors: Joffe
authors: Pauli
authors: P
authors: Puukka
authors: Toshie
authors: T
authors: Noda
authors: Nina
authors: N
authors: Lindberg
mesh_terms: D000293:Adolescent; D000296:Adolescent Psychiatry / Q000706:statistics & numerical data*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006760:Hospitalization; D006801:Humans; D007297:Inpatients / Q000523:psychology / Q000706:statistics & numerical data; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D015995:Prevalence; D012042:Registries / Q000706:statistics & numerical data; D012149:Restraint, Physical / Q000706:statistics & numerical data*; D013405:Suicide; D014754:Violence / Q000523:psychology