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Rates and risk factors of coercive measure use in inpatient child and adolescent mental health services: a systematic review and narrative synthesis
Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
Luleå University of Technology, Department of Health, Education and Technology, Health, Medicine and Rehabilitation. Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden; Department of Psychology, Uppsala University, Uppsala, Sweden.ORCID iD: 0000-0002-1019-0245
Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
2024 (English)In: Lancet psychiatry, ISSN 2215-0374, E-ISSN 2215-0366, Vol. 11, no 10, p. 839-852Article, review/survey (Refereed) Published
Abstract [en]

Reducing the use of coercive measures in inpatient child and adolescent mental health services (CAMHS) requires an understanding of current rates and associated factors. We conducted a systematic review of research published between Jan 1, 2010, and Jan 10, 2024, addressing rates and risk factors for mechanical, physical, or pharmacological restraint, seclusion, or forced tube feeding in inpatient CAMHS. We identified 30 studies (including 39 027 patients or admissions) with low risk of bias. Median prevalence was 17·5% for any coercive measure, 27·7% for any restraint, and 6·0% for seclusion. Younger age, male sex, ethnicity or race other than White, longer stay, and repeated admissions were frequently linked to coercive measure use. Variable rates and conflicting risk factors suggest that patient traits alone are unlikely to determine coercive measure use. More research, especially in the form of nationwide studies, is needed to elucidate the impact of care and staff factors. Finally, we propose reporting guidelines to improve comparisons over time and settings.

Place, publisher, year, edition, pages
Elsevier, 2024. Vol. 11, no 10, p. 839-852
National Category
Psychology (excluding Applied Psychology) Psychiatry
Research subject
Psychology
Identifiers
URN: urn:nbn:se:ltu:diva-108478DOI: 10.1016/s2215-0366(24)00204-9ISI: 001321545000001PubMedID: 39121879Scopus ID: 2-s2.0-85202059184OAI: oai:DiVA.org:ltu-108478DiVA, id: diva2:1887263
Funder
Swedish Research Council, 2021-06369Stockholm County Council, RS2022-0674
Note

Validerad;2024;Nivå 2;2024-11-15 (hanlid);

Available from: 2024-08-07 Created: 2024-08-07 Last updated: 2024-11-20Bibliographically approved

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Rozental, Alexander

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