In Norway there are substantial regional differences in the use of coercive measures in mental health care. There is also variation in use of coercion between mental health care institutions. At present Norwegian authorities are revising an Action Plan from 2006, aiming to reduce the use of coercion and to improve the quality of mental health services when coersive measures are used in accordance with the mental health act.
In this systematic review interventions intended to reduce the use of coercive measures in mental health services for adults have been examined.
Main findings:
Joint crisis plans may reduce the number of compulsory admissions, but the documentation was of low quality.
Systematic evaluation of aggressive behaviour in patients admitted to an acute psychiatric ward, may reduce the use of restraint and seclusion, but the documentation was of low quality.
For the other interventions 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 servies for adults.
We included 12 studies. None of the included studies were conducted in Norway. However, the studies examined the effect of interventions that are used in Norway, such as joint crisis plans, risk assessment, Assertive Community Treatment teams (ACT-teams), crisis resolution teams, and use of written patient contracts, such as booklets containing treatment options.
Keywords: Coersion; Restraint, Physical; Commitment of Mentally Ill; Mental Health.
Copyright ©2012 by The Norwegian Institute of Public Health (NIPH).