Coercive Measuresin Pandemic Psychiatric Care — Retrospective Study

Abstract

Coercion raises serious ethical and legal issues in psychiatric care. Coercive medical measures are applied in psychiatric institutions for protective purposes. Alcoholism is a social and medical problem because it especially affects the behavior of the individual. Alcohol consumption can catalyze exacerbations of mental illness and predispose to behaviors with an increased risk of violence. Aim: The purpose of this study is to illustrate medical and legal issues related to coercive measures in emergency psychiatric care during the pandemic. Methods: The study is retrospective, and the data were taken from the observation sheets of patients in the period between March 1, 2020–March 31, 2021, in acute section II in the Institute of Psychiatry "Socola" Iasi. Results: Of those who required coercive measures during hospitalization, most were restraint for symptoms such as: self-aggression and aggression towards others. Mechanical restraint measures were also necessary in cases with hallucinatory-delusional symptoms, associated with self-aggression and aggression towards others. The share of hospitalized patients for alcohol abuse, who required coercive measures, was significantly higher during the pandemic. Conclusion: Manifestations of violence among patients with major mental disorders are rare. Mechanical restraint was necessary especially in those who had self-aggression and aggression towards others, symptoms secondary to alcohol consumption. Alcohol consumption amplifies the psychological imbalance in the context of the COVID-19 pandemic.