P-659 - The use of coercive measures within forensic psychiatry

Abstract

Introduction The use of coercive measures within forensic psychiatry has generated much debate across public, professional and academic domains. The use of restraint, seclusion and rapid tranquillisation challenge the key principles of healthcare as well as individual human rights. Objectives To conduct a systematic review of the literature between the years 1980–2010, examining empirical research studies into the use of coercive measures within forensic psychiatry Aims To examine current literature; frequencies and variations of coercive measures used within forensic psychiatry Methods A systematic literature search was conducted using the electronic databases ASSIA, BHI, CINAHL, EMBASE, MEDLINE, PAIS, PsycINFO and Sociological Abstracts. Results Twenty-five empirical papers were elicited from the literature search. Younger patients or those newly admitted were restrained and/or secluded most often. Findings relating to gender and diagnoses were ambiguous. Interestingly, no significant differences were found between patient ethnicity and use of restraint and/or seclusion. Limited studies related to staff and patient experiences. Both staff and patients were documented as feeling anxious and angry surrounding coercive experiences. Staff perceptions, roles and responsibilities were suggested to influence decision-making and practice in the use of coercive measures. Conclusions Whilst the use of coercive measures remains a controversial method of practice, variations have been found in the use of coercive measures. Differences in ward atmosphere, staffing and patients have all been suggested as contributing factors. More research is required however, into how these varying factors might interact and contribute towards reducing coercive practice.