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Staff attitudes and thoughts about the use of coercion in acute psychiatric wards

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Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Purpose

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.

Method

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.

Results

Multilevel analysis showed that there was significant variance among wards, estimated to be about 8–11% of the total variance on three scales.

Conclusions

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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References

  1. Hoyer G (2008) Involuntary hospitalization in contemporary mental health care. Some (still) unanswered questions. J Mental Health 17(3):281–292

    Article  Google Scholar 

  2. Kallert TW (2008) Coercion in psychiatry. Curr Opin Psychiatry 21(5):485–489

    Article  PubMed  Google Scholar 

  3. Salize HJ, Dressing H (2004) Epidemiology of involuntary placement of mentally ill people across the European Union. Br J Psychiatry 184:163–168

    Article  PubMed  Google Scholar 

  4. 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

    Article  PubMed  Google Scholar 

  5. 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

    Article  PubMed  Google Scholar 

  6. Okin RL (1985) Variation among state hospitals in use of seclusion and restraint. Hosp Community Psychiatry 36(6):648–652

    PubMed  CAS  Google Scholar 

  7. 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

    PubMed  CAS  Google Scholar 

  8. 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

    Article  PubMed  Google Scholar 

  9. 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

    PubMed  Google Scholar 

  10. 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

    Google Scholar 

  11. 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

    Google Scholar 

  12. 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

    Article  PubMed  Google Scholar 

  13. 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

    Article  PubMed  Google Scholar 

  14. 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

    Article  PubMed  CAS  Google Scholar 

  15. 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

    Article  PubMed  Google Scholar 

  16. 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

    Article  PubMed  Google Scholar 

  17. Hoyer G, Lidz CW, Engberg M, Kaltiala-Heino R, Kjellin L, Sigurjonsdottir M (2002) Measurements of perceived coercion; methodological problems. Eur Psychiatry 17:89S

    Article  Google Scholar 

  18. 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

    Article  Google Scholar 

  19. 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

    Article  PubMed  Google Scholar 

  20. 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

    Article  PubMed  Google Scholar 

  21. Brooks RA (2006) US Psychiatrists’ beliefs and wants about involuntary civil commitment grounds. Int J Law Psychiatry 29(1):13–21

    Article  PubMed  Google Scholar 

  22. Klinge V (1994) Staff opinions about seclusion and restraint at a state forensic hospital. Hosp Community Psychiatr 45(2):138–141

    CAS  Google Scholar 

  23. 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

    Article  PubMed  CAS  Google Scholar 

  24. 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

    Article  PubMed  Google Scholar 

  25. Wynn R (2004) Restraint and seclusion in a Norwegian university psychiatric hospital. University in Tromsø, Tromsø

    Google Scholar 

  26. Bohner G, Wänke M (2002) Attitudes an attitude change. Psychology Press, UK

    Google Scholar 

  27. Bråten S (1973) Model monopoly and communication: systems theoretical notes on democratization. Acta Sociol 16(2):98–107

    Article  Google Scholar 

  28. Leyland A, Goldsted H (2001) Multilevel modelling of health statistics. Wiley, Chichester

    Google Scholar 

  29. 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

    Article  PubMed  Google Scholar 

  30. 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

    PubMed  CAS  Google Scholar 

  31. 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

    Article  PubMed  CAS  Google Scholar 

  32. 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

    Article  PubMed  Google Scholar 

  33. Hox J (2002) Multilevel analysis: techniques and applications. Laurence Erlbaum Associates Inc. Publishers, NJ

    Google Scholar 

  34. 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

  35. 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

    Article  PubMed  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. SINTEF Health Service Research, P.O.Box 124, Blindern, 0314, Oslo, Norway

    Tonje Lossius Husum & Johan Haakon Bjørngaard

  2. Institute of Psychiatry, University of Oslo, Oslo, Norway

    Arnstein Finset

  3. Division of Mental Health Services, Akershus University Hospital, Oslo, Norway

    Torleif Ruud

  4. Department of Community Medicine and General Practice, Norwegian University of Science and Technology, Oslo, Norway

    Johan Haakon Bjørngaard

  5. Institute of Clinical Medicine, University of Oslo, Oslo, Norway

    Torleif Ruud

Authors
  1. Tonje Lossius Husum
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  2. Johan Haakon Bjørngaard
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  3. Arnstein Finset
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  4. Torleif Ruud
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Corresponding author

Correspondence to Tonje Lossius Husum.

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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

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  • DOI: https://doi.org/10.1007/s00127-010-0259-2

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