title: One-year incidence and prevalence of seclusion: Dutch findings in an international perspective.
abstract: BACKGROUND
  The Netherlands started a nationwide coercion reduction program in 2007. In 2011, accurate registration of coercive measures became obligatory by law.
  
  
  OBJECTIVE
  The aim of this study was to compare number and duration of coercive measures in the Netherlands with international data.
  
  
  METHODS
  2011 data on coercive measures were collected, using a system developed in Germany. To understand determinants of coercion, multilevel logistic regression was performed.
  
  
  RESULTS
  12.0 % (n = 5169) of patients (n = 42.960) in 2011 experienced at least one coercive measure. Exposure to coercion was comparable to other countries, and duration was higher. Medication use seemed to half average times in seclusion. In the Netherlands, coercion mainly constituted of seclusion and occurred in bipolar and psychotic disorders. In Germany, coercion was mostly mechanical restraint and occurred in organic disorders and schizophrenia.
  
  
  CONCLUSIONS
  Gathering comprehensive data allows comparisons between countries, increasing our understanding of the impact of different cultures, legislation and health care systems on coercion. In the Netherlands, seclusion is still the main type of coercion, despite significant improvements in the last few years. It is shorter when applied in combination with enforced medication.
authors.affiliation: GGnet Community Mental Health Centre, Warnsveld, The Netherlands. E.Noorthoorn@ggnet.nl.|Dutch Case Register Coercive Measures, Altrecht Aventurijn, Den Dolder, The Netherlands. E.Noorthoorn@ggnet.nl.
authors.forename: Eric
authors.initials: E
authors.lastname: Noorthoorn
authors.affiliation: Bangor University, Bangor, Wales, United Kingdom.|Mysore Medical College and Research Institute, Mysore, India.|Wrexham Community Mental Health Team, University Health Board, Wrexham Maelor Hospital, Wrexham, Wales.
authors.forename: Peter
authors.initials: P
authors.lastname: Lepping
authors.affiliation: Hogeschool Windesheim, Zwolle, The Netherlands.|Dutch Case Register Coercive Measures, Altrecht Aventurijn, Den Dolder, The Netherlands.
authors.forename: Wim
authors.initials: W
authors.lastname: Janssen
authors.affiliation: Department of Psychiatry, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Adriaan
authors.initials: A
authors.lastname: Hoogendoorn
authors.affiliation: Radboud University of Nijmegen, Nijmegen, The Netherlands.|Altrecht Aventurijn, Den Dolder, The Netherlands.
authors.forename: Henk
authors.initials: H
authors.lastname: Nijman
authors.affiliation: Department of Medical Humanities, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Guy
authors.initials: G
authors.lastname: Widdershoven
authors.affiliation: Centres for Psychiatry Suedwuerttemberg, Ulm University, Ulm, Germany.
authors.forename: Tilman
authors.initials: T
authors.lastname: Steinert
mesh_terms: D003068:Coercion; D004358:Drug Therapy / Q000706:statistics & numerical data*; D005260:Female; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D038622:Internationality; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D055361:Multilevel Analysis; D009426:Netherlands; D010356:Patient Isolation / Q000706:statistics & numerical data*; D015995:Prevalence; D012149:Restraint, Physical / Q000706:statistics & numerical data*
keywords: Coercion; Determinants; International comparison; Restraint; Seclusion