Legal regulation and policy on the use of restraint and coercive measures in health care institutions in the Netherlands

Abstract

Dutch psychiatric hospitals have been engaged in a range of projects to reduce the use of seclusion and others forms of coercive treatment since 1998. A key factor in allowing for such longitudinal evaluations was mandatory registration of all individual uses of restraint and coercive treatment in all psychiatric institutions. This chapter briefly sets out relevant background information about the Dutch health care system and introducing key terms. It examines the legal framework in the Netherlands which regulates the use of restraint and coercive measures in psychiatric institutions, as well as institutions housing people with intellectual disabilities and people with psychogeriatric conditions. The chapter also examines the registration system, which was designed to record each use of restraint, coercion and involuntary treatment in Dutch psychiatric institutions, and the controversies surrounding the system related to patient privacy. It analyses the factors which seem to have influenced the (reduced) use of coercive measures, and particularly seclusion, in psychiatric institutions in the Netherlands.