Opinions About Treatment Modalities Among Patients Involuntarily Committed to a Forensic Psychiatric Hospital in Finland

Abstract

Patient satisfaction studies concerning various treatment modalities are few among involuntary forensic psychiatric treatment. They indicate general satisfaction with medication, interactive treatment and occupational therapy but dissatisfaction with lack of privacy, insufficiently explained rules and inadequately explained reasons of seclusion. In order to find out patients' opinions concerning prerequisites of cooperation, we investigated by using an anonymous questionnaire, opinions and general satisfaction with various forms of therapy, and associations of factors related to different treatment modalities among a population (N = 260) of seriously ill forensic psychiatric patients. Statistical analyses (chi-square, factor analysis, logistic regression) revealed that, according to patients' experiences, their personal psychiatric nurses were helpful as well as their psychiatrists in spite of their restrictive functions. Medication and restrictions were considered helpful by those patients who experienced harmful effects from interactive treatment, and seclusion was considered helpful by those patients who experienced helpful effects from psychiatrists and family. To reach synergistic advantages in the attempt to make treatment more based on cooperation and to reduce violent behavior, the challenge is to teach the nursing staff to educate patients on the importance of medication and on the acute phases of psychosis, when even seclusion may be needed, in the context of safe therapeutic relationship.

Key Words:

• Forensic psychiatric treatment
• patient satisfaction
• personal psychiatric nurse
• restrictive treatment
• seclusion