Prevalence and risk factors for seclusion and restraint: results of a retrospective analysis.

Background: The reduction of coercion is a central challenge of inpatient mental health services. Little is known about the use of seclusion and restraint in open-door settings. This work aims to analyse the prevalence and risk factors of coercive measures in open inpatient wards of a Swiss university psychiatric hospital.

Ethical dilemmas in the care of patients suffering from psychotic catatonia: a case report.

Background: Coercive measures in psychiatric practice are controversial due to their potential for severe negative effects. Ethical debates focus on respecting autonomy, minimizing damaging effects, and acting in the patient's best interest.

Case: We present a unique case of a young patient suffering from a first episode of catatonic psychosis, in which striking this balance was especially difficult given the patient's complete mutism and opposition, given the absence of immediate danger to herself or others, the lack of anamnestic information, and her avoidance of social support, which would have meant that she would not have encountered psychiatric care, were it not for an exceptional government plan in place at the time of hospitalization.

Experience of violence and attitudes of staff members towards coercion in psychiatric settings: observational study.

Background: Among important dimensions related to the use of coercive measures, professionals' attitude towards coercion is of particular interest. Little is known about how experiences of violence in the workplace might influence these attitudes.

Aims: The present study aimed to investigate potential correlates of attitudes towards coercion, especially experiences of violence in the workplace.

Psychiatric manifestations in moyamoya disease: more than a puff of smoke? a systematic review and a case-reports meta-analysis.

Introduction: Moyamoya disease (MMD) is a life-threatening condition characterized by stenosis of intracranial arteries. Despite the frequency and the impact of psychiatric symptoms on the long-term prognosis and quality of life of MMD patients, no systematic review on this topic exists.

Methods: This systematic review and meta-analysis included 41 studies (29 being case reports), from PubMed, Scopus, Embase until 27/3/2023, on MMD patients exhibiting psychiatric symptoms.

Relationship between perceived coercion and perceived justification of coercive measures - secondary analysis of a randomized-controlled trial.

Background: Subjective perception of coercion has gained attention as an important outcome. However, little is known about its relation to patients' appraisal of the justification of coercive measures. The present study aims to analyze the relationship between patients' appraisal of the justification of coercive measures and their level of perceived coercion.

Treatment without consent in adult psychiatry inpatient units: a retrospective study on predictive factors.

Background: Coercion is one of the most important challenges in mental health. In Switzerland, forced medication can be applied during an emergency (Art. 435 of the Civil Code) or over a longer period in case of endangerment of others or oneself (Art.

Admissions to psychiatric inpatient services and use of coercive measures in 2020 in a Swiss psychiatric department: An interrupted time-series analysis.

Background: The CoVID pandemic and the associated lockdown had a significant impact on mental health services. Inpatient services faced the challenge of offering acute psychiatric while implementing strict infection control measures. There is, however, a lack of studies investigating the use of coercive measures during the pandemic and their relation to hospitalizations and symptom severity.

Effect of Seclusion on Mental Health Status in Hospitalized Psychiatric Populations: A Trial Emulation using Observational Data.

The use of coercive practices, i.e., interventions against a person's will, is controversial.

Effects of Recovery-Orientation on the Use of Forced Medication and Maximum Daily Drug Dose: The "Weddinger Modell".

The aim of the present study was to analyze the effects of the implementation of the Recovery-orientated psychiatric care concept "Weddinger Modell" on the incidence of forced medication, the total number of forced medication incidents per affected case, the maximum dose of a singular forced medication and the maximum voluntary daily drug dose of different psychotropic drugs administered during an inpatient stay. This retrospective case-control study included 234 patients. A pre/post-comparison of patients on two acute psychiatric wards before (control group, = 112) and after (intervention group, = 122) the implementation of the Weddinger Modell in 2010 was performed.

Psychiatric emergency admissions during and after COVID-19 lockdown: short-term impact and long-term implications on mental health.

Background: The 'lockdown' measures, adopted to restrict population movements in order to help curb the novel coronavirus disease 2019 (COVID-19) pandemic, contributed to a global mental health crisis. Although several studies have extensively examined the impact of lockdown measures on the psychological well-being of the general population, little is known about long-term implications. This study aimed to identify changes in psychiatric emergency department (ED) admissions between two 8-week periods: during and immediately after lifting the lockdown.

The Role of Implicit and Explicit Staff Attitudes in the Use of Coercive Measures in Psychiatry.

Many determinants leading to the use of different coercive measures in psychiatry have been widely studied and it seems that staff attitudes play a crucial role when it comes to the decision-making process about using coercion. However, research results about staff attitudes and their role in the use of coercive measures are inconsistent. This might be due to a focus on self-report studies asking for explicit answers, which involves the risk of bias.

Prevalence and risk factors for seclusion and restraint in old-age psychiatry inpatient units.

Background And Objectives: Coercion in psychiatry is legally tolerated as a last resort. The reduction of the use of coercion is a shared goal of hospital administrators, medical and nursing staff and representatives of patients and families but requires the identification of risk factors for coercion. These risk factors in geriatric psychiatric inpatient settings are not well known, especially regarding seclusion.

Impact of the COVID-19 Pandemic on Psychiatric Admissions to a Large Swiss Emergency Department: An Observational Study.

The coronavirus disease 2019 (COVID-19) pandemic is a public health emergency with profound mental health consequences. The psychiatric emergency department (ED) plays a key role during this mental health crisis. This study aimed to investigate differences in admissions at a Swiss psychiatric ED from 1 April to 15 May during a "pandemic-free" period in 2016 and a "during-pandemic" period in 2020.

Effect of standardized post-coercion review session on symptoms of PTSD: results from a randomized controlled trial.

Objective: Post-coercion review is increasingly regarded as a mean to reduce the negative consequences of coercive interventions, including the development of posttraumatic symptoms. However, the efficacy of this intervention in preventing posttraumatic symptoms or PTSD has not been sufficiently studied. The objective of this study is to examine the influence of a single, standardized post-coercion review session on the development or exacerbation of PTSD symptoms in patients with psychotic disorders.

Correlates of seclusion and restraint of patients admitted to psychiatric inpatient treatment via a German emergency room.

Coercive measures in psychiatry are associated with negative consequences for both patients and staff. When it comes to preventing coercive measures, innovative models of care like the Weddinger Modell focusing on recovery, participation and supported decision-making have proven successful. However, observations from clinical practice show that emergency admissions to psychiatric facilities pose a great challenge in this regard and that most coercive measures take place during or shortly after emergency admission.

[Effects of the Psychiatric Care Concept "Weddinger Modell" on Mechanical Coercive Measures].

The aim of the present study was to analyze the effects of the implementation of the Recovery-orientated psychiatric care concept "Weddinger Modell" on mechanical coercive measures. A retrospective case-control study design was implemented, investigating 375 patients treated in in-patient care on three acute psychiatric wards who were selected at four different reporting dates. The study compared two groups of patients, one treated according to the Weddinger Modell (intervention group; n = 122) and the other one conventionally (control group; n = 235).

[Therapeutic attitudes and structures in (open) acute psychiatry: the Wedding model].

The Wedding model is a recovery-orientated treatment model that was implemented in 2010 as part of a complex change project in the Department of Psychiatry of the Charité at the St. Hedwig Hospital (PUK-SHK). According to this model, all ward structures were changed in order to promote transparency, participation, trialogue and multiprofessional work.

[Standardized Debriefing of Coercive Measures on Psychiatric Acute Wards: A Pilot Study].

Objective: The present pilot study investigates the feasibility of a standardized debriefing measure of coercive interventions, for which a guideline has been developed.

Methods: 12 debriefing sessions were conducted and participating patients and staff members were asked about their perception of the intervention and its benefits. A quantitative and qualitative questionnaire was used and 8 expert-interviews conducted.

[Contributions to reduce coercion in psychiatric care].

Reduction in coercion in psychiatric treatment requires successful interaction between changes in structural preconditions and therapeutic processes, as well as in individual therapeutic skills and attitudes. The article gives an overview of current approaches and possibilities to minimize the use of coercive interventions and to create non-violent and participative therapeutic settings. These opportunities are discussed against the background of structural and staff resources, social and legal aspects, as well as subjective experience of patients and their right to protection and treatment in phases when freedom of will and self- determination are compromised.

Can "Model Projects of Need-Adapted Care" Reduce Involuntary Hospital Treatment and the Use of Coercive Measures?

Intensive outpatient models of need-adapted psychiatric care have been shown to reduce the length of hospital stays and to improve retention in care for people with severe mental illnesses. In contrast, evidence regarding the impact of such models on involuntary hospital treatment and other coercive measures in inpatient settings is still sparse, although these represent important indicators of the patients' wellbeing. In Germany, intensive models of care still have not been routinely implemented, and their effectiveness within the German psychiatric system is only studied in a few pioneering regions.

Challenges and Perspectives in Bridging In- and Outpatient Sectors: The Implementation of Two Alternative Models of Care and Their Effect on the Average Length of Stay.

New models of care aimed at reinforcing the outpatient sector have been introduced in Germany over the last few years. Initially, a subscription-based model ("integrated care") was introduced in 2012 in the Immanuel Klinik Rüdersdorf, wherein patients had to actively subscribe to the integrated care program. This integrated care model was replaced after 2 years by a subscription-free "model project," in which all patients insured by the contracting insurance company took part in the program.

[Subscription Rates of Psychiatric Patients to an Integrated Care Program in the Context of a Psychiatric Model Project].

In the past years different model projects have been developed in Germany to counteract the known deficits of the German psychiatric care system. Among these, an "integrated care" model project has been set up which offers a more flexible way of managing psychiatric care, especially for patients with a severe mental illness. It however implies an active subscription to the program.