The use of seclusion and restraint during 15 years -- a nationwide study in Finland

Keski-Valkama, Alice; Sailas, Eila; Eronen, Markku; Lönnqvist, Jouko; Kaltiala-Heino, Riittakerttu
January 2007
BMC Psychiatry;2007 Supplement 1, Vol. 7, Special section p1
Academic Journal
Background Internationally, concerns over the use of seclusion and restraint in psychiatric care have increased over the past decades. In Finland, restriction of freedom and use of coercion in psychiatry are regulated by the Mental Health Act of 1991. After its implementation, the Act (revision 2002) has become more restrictive and specified in relation to using coercion. Objective: This study investigated the nationwide trends in the use of seclusion and restraint in Finland over a fifteen-year span (1990-2004) that was characterised by legislative changes. Methods The data was collected during a predetermined week in 1990, 1991, 1994, 1998, and 2004 using the National Hospital Discharge Register and a structured postal survey of Finnish psychiatric hospitals. Results Notwithstanding the legislative changes, the use of seclusion and restraint did not change in Finland during 15 years. Conclusion Ethical and clinical considerations are discussed.


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