There are substantial regional differences in the use of coercive measures in mental health in Norway. The Norwegian Directorate of Health is working with a national standardized package of procedures for improving and reducing use of coercion in mental health care and commissioned an updated systematic review to support this work. We summarized 21 studies about interventions for reducing seclusion and restraint in mental health care for adults. The report is an update of a previous systematic review on the same topic conducted in 2012. We included eight new studies in the updated report.
Main findings:
Joint crisis plans probably reduce the number of compulsory admissions.
Systematic evaluation of aggressive behaviour in patients admitted to an acute psychiatric ward, may reduce the use of restraint and seclusion.
Couselling towards staff in high security wards may reduce seclusion and restraint.
For the other interventions (such as community-care network, involuntary outpatient commitment program and personal advocacy for inpatients) conclusions could not be drawn.
Further research is needed in order to draw more robust conclusions about the effect of interventions intended to reduce coercive measures, seclusion and restraint, in mental health services.
We included 21 studies, of which two were conducted in Norway. All included studies, examined the effect of interventions that are used in Norway, for example joint crisis plans, risk assessment, Assertive Community Treatment teams (ACT-teams), crisis resolution teams and use of written patient contracts.
Keywords: Coersion; Restraint, physical; Commitment of mentally ill.
Copyright © 2017 by The Norwegian Institute of Public Health (NIPH).