Previous research has shown considerable differences in how often coercive measures are used in mental health care between groups of patients, institutions and geographical areas. Staff attitudes towards the use of coercion have been put forward as a factor that may influence these differences.
This study investigates the attitudes to coercion in 651 staff members within 33 Norwegian acute psychiatric wards. The newly developed Staff Attitude to Coercion Scale was used to measure staff attitudes.
Multilevel analysis showed that there was significant variance among wards, estimated to be about 8–11% of the total variance on three scales.
Despite substantial differences in attitudes among wards, most of the variance could be attributed to individual staff level factors. Hence, it is likely that staff attitudes are influenced, to a large extent, by each individual staff member’s personality and values.
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Hoyer G (2008) Involuntary hospitalization in contemporary mental health care. Some (still) unanswered questions. J Mental Health 17(3):281–292
Kallert TW (2008) Coercion in psychiatry. Curr Opin Psychiatry 21(5):485–489
Salize HJ, Dressing H (2004) Epidemiology of involuntary placement of mentally ill people across the European Union. Br J Psychiatry 184:163–168
Bowers L, van der Werf B, Vokkolainen A, Muir-Cochrane E, Allan T, Alexander J (2007) International variation in containment measures for disturbed psychiatric inpatients: a comparative questionnaire survey. Int J Nurs Stud 44(3):357–364
Korkeila JA, Tuohimaki C, Kaltiala-Heino R, Lehtinen V, Joukamaa M (2002) Predicting use of coercive measures in Finland. Nord J Psychiatry 56(5):339–345
Okin RL (1985) Variation among state hospitals in use of seclusion and restraint. Hosp Community Psychiatry 36(6):648–652
Carpenter MD, Hannon VR, McCleery G, Wanderling JA (1988) Variations in seclusion and restraint practices by hospital location. Hosp Community Psychiatry 39(4):418–423
Hoyer G, Kjellin L, Engberg M, Kaltiala-Heino R, Nilstun T, Sigurjonsdottir M et al (2002) Paternalism and autonomy: a presentation of a Nordic study on the use of coercion in the mental health care system. Int J Law Psychiatry 25(2):93–108
Kallert TW, Glockner M, Onchev G, Raboch J, Karastergiou A, Solomon Z et al (2005) The EUNOMIA project on coercion in psychiatry: study design and preliminary data. World Psychiatry 4(3):168–172
Parker C (2007) Developing mental health policy: a human rights perspective. In: Knapp M, McDavid D, Mossialos E, Thornicroft G (eds) Mental Health Policy and Practice across Europe: the future direction of mental health care. Open University Press, PA, pp 308–335
WHO (2005) WHO resource book on mental health, human rights and legislation. Stop exclusion, dare to care. WHO Library cataloguing in publication data. World Health Organization, Geneva
Kjellin L, Ostman O, Ostman M (2008) Compulsory psychiatric care in Sweden—development 1979–2002 and area variation. Int J Law Psychiatry 31(1):51–59
Steinert T, Lepping P, Baranyai R, Hoffmann M, Leherr H (2005) Compulsory admission and treatment in schizophrenia: a study of ethical attitudes in four European countries. Soc Psychiatry Psychiatr Epidemiol 40(8):635–641
Olofsson B, Norberg A (2001) Experiences of coercion in psychiatric care as narrated by patients, nurses and physicians. J Adv Nurs 33(1):89–97
Martin V, Kuster W, Baur M, Bohnet U, Hermelink G, Knopp M et al (2007) Incidence of coercive measures as an indicator of quality in psychiatric hospitals Problems of data recording and processing, preliminary results of a benchmarking study. Psychiatr Prax 34(1):26–33
Bindman J, Reid Y, Szmukler G, Tiller J, Thornicroft G, Leese M (2005) Perceived coercion at admission to psychiatric hospital and engagement with follow-up—a cohort study. Soc Psychiatry Psychiatr Epidemiol 40(2):160–166
Hoyer G, Lidz CW, Engberg M, Kaltiala-Heino R, Kjellin L, Sigurjonsdottir M (2002) Measurements of perceived coercion; methodological problems. Eur Psychiatry 17:89S
Iversen KI, Hoyer G, Sexton H, Gronli OK (2002) Perceived coercion among patients admitted to acute wards in Norway. Nord J Psychiatry 56(6):433–439
Alem A, Jacobsson L, Lynoe N, Kohn R, Kullgren G (2002) Attitudes and practices among Ethiopian health care professionals in psychiatry regarding compulsory treatment. Int J Law Psychiatry 25(6):599–610
Bowers L, Alexander J, Simpson A, Ryan C, Carr-Walker P (2004) Cultures of psychiatry and the professional socialization process: the case of containment methods for disturbed patients. Nurse Educ Today 24(6):435–442
Brooks RA (2006) US Psychiatrists’ beliefs and wants about involuntary civil commitment grounds. Int J Law Psychiatry 29(1):13–21
Klinge V (1994) Staff opinions about seclusion and restraint at a state forensic hospital. Hosp Community Psychiatr 45(2):138–141
Kullgren G, Jacobsson L, Lynoe N, Kohn R (1996) Practices and attitudes among Swedish psychiatrists regarding the ethics of compulsory treatment. Acta Psychiatr Scand 93(5):389–396
Lepping P, Steinert T, Gebhardt RP, Rottgers HR (2004) Attitudes of mental health professionals and lay-people towards involuntary admission and treatment in England and Germany—a questionnaire analysis. Eur Psychiatry 19(2):91–95
Wynn R (2004) Restraint and seclusion in a Norwegian university psychiatric hospital. University in Tromsø, Tromsø
Bohner G, Wänke M (2002) Attitudes an attitude change. Psychology Press, UK
Bråten S (1973) Model monopoly and communication: systems theoretical notes on democratization. Acta Sociol 16(2):98–107
Leyland A, Goldsted H (2001) Multilevel modelling of health statistics. Wiley, Chichester
Wynn R (2003) Staff’s attitudes to the use of restraint and seclusion in a Norwegian university psychiatric hospital. Nord J Psychiatry 57(6):453–459
Klimitz H, Uhlemann H, Fahndrich E (1998) Do we use restraints too often? Indication, frequency and conditions of restraints on a general psychiatric unit. Psychiatr Prax 25(5):235–239
Wing JK, Beevor AS, Curtis RH, Park SB, Hadden S, Burns A (1998) Health of the Nation Outcome Scales (HoNOS). Research and development. Br J Psychiatry 172:11–18
Husum TL, Finset A, Ruud T (2008) The Staff Attitude to Coercion Scale (SACS): reliability, validity and feasibility. Int J Law Psychiatry 31(5):417–422
Hox J (2002) Multilevel analysis: techniques and applications. Laurence Erlbaum Associates Inc. Publishers, NJ
Bowers L, Nijman H, Simpson A, Jones J (2010) The relationship between leadership, teamworking, structure, burnout and attitude to patients on acute psychiatric wards. Soc Psychiatry Psychiatr Epidemiol
Falkum E, Forde R (2001) Paternalism, patient autonomy, and moral deliberation in the physician–patient relationship. Attitudes among Norwegian physicians. Soc Sci Med 52(2):239–248
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Husum, T.L., Bjørngaard, J.H., Finset, A. et al. Staff attitudes and thoughts about the use of coercion in acute psychiatric wards. Soc Psychiatry Psychiatr Epidemiol 46, 893–901 (2011). https://doi.org/10.1007/s00127-010-0259-2
- Staff attitudes
- Acute psychiatric wards
- Multilevel analysis