title: Variables associated with the use of coercive measures on psychiatric patients in Spanish penitentiary centers.
abstract: We have studied the use of coercive medical measures (forced medication, isolation, and mechanical restraint) in mentally ill inmates within two secure psychiatric hospitals (SPH) and three regular prisons (RP) in Spain. Variables related to adopted coercive measures were analyzed, such as type of measure, causes of indication, opinion of patient inmate, opinion of medical staff, and more frequent morbidity. A total of 209 patients (108 from SPH and 101 from RP) were studied. Isolation (41.35%) was the most frequent coercive measure, followed by mechanical restraint (33.17%) and forced medication (25.48%). The type of center has some influence; specifically in RP there is less risk of isolation and restraint than in SPH. Not having had any previous imprisonment reduces isolation and restraint risk while increases the risk of forced medication, as well as previous admissions to psychiatric inpatient units does. Finally, the fact of having lived with a partner before imprisonment reduces the risk of forced medication and communication with the family decreases the risk of isolation. Patients subjected to a coercive measure exhibited a pronounced psychopathology and most of them had been subjected to such measures on previous occasions. The mere fact of external assessment of compliance with human rights slows down the incidence of coercive measures.
authors.affiliation: Department of Legal and Forensic Medicine, Faculty of Medicine, University of Córdoba, Avenida Menéndez Pidal s/n, 14071 Córdoba, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Girela
authors.affiliation: Medical Services, Secure Psychiatric Hospital of Alicante, Spain.
authors.forename: A
authors.initials: A
authors.lastname: López
authors.affiliation: Medical Services, Prison of Málaga, Spain.
authors.forename: L
authors.initials: L
authors.lastname: Ortega
authors.affiliation: Medical Services, Prison of Córdoba, Spain.
authors.forename: J
authors.initials: J
authors.lastname: De-Juan
authors.affiliation: Medical Services, Prison of Granada, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Ruiz
authors.affiliation: Medical Services, Secure Psychiatric Hospital of Sevilla, Spain.
authors.forename: J I
authors.initials: JI
authors.lastname: Bosch
authors.affiliation: Medical Services, Secure Psychiatric Hospital of Alicante, Spain.
authors.forename: L F
authors.initials: LF
authors.lastname: Barrios
authors.affiliation: Department of Biostatistics, University of Granada, Spain.
authors.forename: J D
authors.initials: JD
authors.lastname: Luna
authors.affiliation: Center of Biomedical Research Network of Mental Health (CIBERSAM), University of Granada, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Torres-González
mesh_terms: D000328:Adult; D001290:Attitude; D005260:Female; D006778:Hospitals, Psychiatric; D006801:Humans; D008297:Male; D028642:Persons with Psychiatric Disorders / Q000523:psychology*; D011330:Prisons