Coercion within Danish psychiatry compared with 10 other European countries

Abstract

Background: In 2008, the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT) criticized the use of mechanical restraint in Denmark and referred to it as ill-treatment. What do other European countries do better? To answer this question, we compared the use of coercive measures regarding psychiatric inpatients in Denmark and comparable European countries. Aims: Comparing coercive measures from Denmark, Sweden, Norway, Finland, Iceland, Belgium, The Netherlands, United Kingdom, Ireland, France and Italy. Methods: Review of international literature and a cross-sectional study performed as a questionnaire survey. Results: Denmark used more mechanical restraint and holding than Finland and Norway; however Sweden used twice as much as Denmark. Finland used more seclusion than did the other countries. Norway was the country that used the smallest amount of physical coercion. Only Norway, Finland, Sweden and Denmark had comparable representative data on coercion. Conclusions: Norway used less physical restraint than Denmark. We could not find any obvious reasons for the differences in the use of physical restraint. Clinical implications: Comparing the factors surrounding coercion between countries may serve as a basis for minimizing coercion and carrying it out in the most acceptable manner for the patients, thereby providing better psychiatric treatment in Europe.

• Coercion
• Mental health
• Psychiatric code
• Restraint

Acknowledgements—The authors wish to thank Mette Dons (Head of Department, the National Board of Health, Copenhagen), Torben Hærslev (Senior Specialist, the National Board of Health, Copenhagen) and Louise Gjørup (Administrative Assistant, the National Board of Health, Copenhagen) for discussions and participation, and Thomas Werge (Head of Research, Mental Health Centre Sct. Hans, Roskilde) for valuable comments and careful reading during the writing process.

Disclosure of interest: The project was partly funded by the National Board of Health. There are no known conflicts of interest, financial, personal, political and academic or others. The authors are responsible for the contents and writing the paper.