[Joint study of seclusion, mechanical restraint and chemical restraint: Pilot study in three French psychiatric hospitals]

Abstract

Psychiatric wards that only exceptionally use isolation and mechanical restraint may be suspected of using "chemical restraint". However, in the case of these services, the hypothesis of a reduction in the general level of restraint can also be formulated. Prior to a comprehensive study to test these hypotheses, the current research aims to assess indicators which define high levels of the use of these measures and a relevant sample. The study was conducted in three facilities with 254 hospitalized patients over a week. Five per cent experienced isolation, 2% mechanical restraint, and 13% received high doses of medication (including "as needed" treatments). These figures are below literature data and national averages. Variances exist among centers, with one showing higher percentages for all three measures. While confirming the feasibility of studying these measures together, the study suggests the need for longer observations and continuous evaluation of prescription practices to better reflect yearly isolation and restraint trends. Future studies should involve more centers and include case studies for a nuanced understanding of administration practices in relation to prescriptions.

Keywords: Antipsychotic agents; Coercion; Coercition; Contention mécanique et isolement; Feasibility studies; Neuroleptiques; Psychiatric Department Hospital; Restraint and seclusion; Service hospitalier de psychiatrie; Études de faisabilité.