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The Uses of Coercive Measures in Forensic Psychiatry: A Literature Review

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The Use of Coercive Measures in Forensic Psychiatric Care

Abstract

Coercive measures are controversial within healthcare and require closer inspection, particularly within forensic psychiatry, where security-orientated restrictions are commonplace. The uses of coercive measures are often justified as a necessity for maintaining safety. Yet, these interventions are in stark contradiction to the autonomous person-centered philosophies that healthcare professionals are trained with, and that healthcare services purport to provide. The examinations of these practices are timely, particularly in light of international legislations to reduce and even eliminate the uses of such interventions and where studies have suggested that coercive methods might have paradoxical effects in provoking further violent and aggressive behaviours [American Psychiatric Association et al. (Learning from each other: Success stories and ideas for reducing restraint/seclusion in behavioural health. 2003); Goren et al. (Journal of Child and Family Studies 2(1):61–73, 1993); National Mental Health Working Group 2005; NICE (Violence and aggression: short term management in mental health, health and community setting. NICE, 2015); Queensland Government (Policy statement on reducing and where possible eliminating restraint and seclusion in Queensland mental health services. http://www.health.gld.gov.uk/mentalhealth/docs/sandrpolicy_081030.pdf, 2008); The MacArthur Research Network (The MacArthur coercion study. http://www.macarthur.virginia.edu/coercion.html, 2004); National Association of State Mental Health Directors (Violence and coercion in mental health settings: Eliminating the use of seclusion and restraint. http://www.nasmhpd.org/general_files/publications/ntac_pubs/networks/SummerFall2002.pdf, 2002)].

This chapter presents a literature review, examining the findings of empirical papers published between January 1980 and June 2015. Particular attention will be given to the rates, frequencies and durations of coercive measures used within forensic psychiatry and the characteristics of those secluded and restrained. The possible predictors and indicators of using coercive measures will be examined, along with and staff and patient attitudes and experiences. In particular, discussions surrounding these findings will draw attention towards the factors that influence the uses of coercive measures and the current challenges and tensions between policy and practice. This chapter suggests that further research is required into exploring what it might mean to reduce the uses of restrictive practices and how this process might be facilitated.

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Authors and Affiliations

  1. School of Health Sciences, University of Nottingham, Nottingham, UK

    Ada Hui

  2. School of Sociology and Social Policy, University of Nottingham, Nottingham, UK

    Hugh Middleton

  3. Nottingham Healthcare NHS Foundation Trust, Nottingham, UK

    Hugh Middleton & Birgit Völlm

  4. Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK

    Birgit Völlm

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  1. Ada Hui
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  2. Hugh Middleton
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Correspondence to Ada Hui .

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Editors and Affiliations

  1. University of Nottingham, Nottingham, United Kingdom

    Birgit Völlm

  2. Department of Forensic Psychiatry, Psychiatric Hosp.of the Univ. of München, München, Germany

    Norbert Nedopil

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Hui, A., Middleton, H., Völlm, B. (2016). The Uses of Coercive Measures in Forensic Psychiatry: A Literature Review. In: Völlm, B., Nedopil, N. (eds) The Use of Coercive Measures in Forensic Psychiatric Care. Springer, Cham. https://doi.org/10.1007/978-3-319-26748-7_9

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  • DOI: https://doi.org/10.1007/978-3-319-26748-7_9

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