Staff and caregiver attitude to coercion in India

Raveesh, Bevinahalli Nanjegowda; Pathare, Soumitra; Noorthoorn, Eric; Gowda, Guru S; Lepping, Peter; Bunders, Joske

doi:10.4103/0019-5545.196847

Cited by 26 publications

(36 citation statements)

References 29 publications

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“…It concluded that the lack of resources is one of the reasons for coercion in India. [17] The drawback of the previous study was that it used SACS which was developed to look at the attitude of coercion among mental health professionals. It was not meant for caregivers, and it was not suitable to assess the ground reality and attitude of Indian caregiver population.…”

Section: Discussionmentioning

confidence: 99%

“…In this study, the majority of caregivers are males and is middle-aged (mean age of 44 years), these findings are in line with the Mysore study findings. [17] Caregivers, who stayed with patients during IP, are mostly family members and from low socioeconomic status. Our study shows that the patients suffering from a severe mental illness such as schizophrenia and other psychotic disorder was 48% and those suffering from mood disorders was 43.5%.…”

Section: Discussionmentioning

confidence: 99%

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Caregivers’ attitude and perspective on coercion and restraint practices on psychiatric inpatients from South India

Gowda

Kumar

Ray

et al. 2019

Journal of Neurosciences in Rural Practice

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Background: Coercion and restraint practices in psychiatric care are common phenomena and often controversial and debatable ethical issue. Caregivers’ attitude and perspective on coercion and restraint practices on psychiatric inpatients have received relatively less research attention till date. Aims: Caregivers’ attitude and perspective on coercion and restraint practices on psychiatric inpatients. Methodology: This is a hospital-based, a descriptive, cross-sectional study. A total of 200 (n = 200) consecutive patient and their caregivers were chosen between June 2013 and September 2014 through computer-generated random numbers sampling technique. We used a semi-structured interview questionnaire to capture caregivers’ attitude and perspective on coercion and restraint practices. Sociodemographic and coercion variable were analyzed using descriptive statistics. McNemar test was used to assess discrete variables. Results: The mean age was 43.8 (±14.9) years. About 67.5% of the caregivers were family members, 60.5% of them were male and 69.5% were from low-socioeconomic status. Caregivers used multiple methods were used to bring patients into the hospital. Threat (52.5%) was the most common method of coercion followed by persuasion (48.5%). Caregivers felt necessary and acceptable to use chemical restraint (82.5%), followed by physical restraint (71%) and electroconvulsive therapy (ECT) (56.5%) during acute and emergency psychiatric care to control imminent risk behavior of patients. Conclusion: Threat, persuasion and physical restraint were the common methods to bring patients to bring acutely disturbed patients to mental health care. Most patients caregivers felt the use of chemical restraint, physical restraint and ECT as necessary for acute and emergency care in patients with mental illness.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Caregivers’ attitude and perspective on coercion and restraint practices on psychiatric inpatients from South India

Gowda

Kumar

Ray

et al. 2019

Journal of Neurosciences in Rural Practice

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“…Thirty-two studies focused on coercion; one study examined prevalence of coercive measures141 and one study explored how the experience of staff might contribute to the use of restrictive practices 210. The attitudes of staff,142 144 211–222 patients145 223–226 and mixed groups143 168 227–230 towards coercion were explored in 25 studies, and 5 studies examined the process of coercive interventions139 140 231 232 and rules of engagement in caring for aggressive patients 233…”

Section: Resultsmentioning

confidence: 99%

Patient safety in inpatient mental health settings: a systematic review

et al. 2019

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ObjectivesPatients in inpatient mental health settings face similar risks (eg, medication errors) to those in other areas of healthcare. In addition, some unsafe behaviours associated with serious mental health problems (eg, self-harm), and the measures taken to address these (eg, restraint), may result in further risks to patient safety. The objective of this review is to identify and synthesise the literature on patient safety within inpatient mental health settings using robust systematic methodology.DesignSystematic review and meta-synthesis. Embase, Cumulative Index to Nursing and Allied Health Literature, Health Management Information Consortium, MEDLINE, PsycINFO and Web of Science were systematically searched from 1999 to 2019. Search terms were related to ‘mental health’, ‘patient safety’, ‘inpatient setting’ and ‘research’. Study quality was assessed using the Hawker checklist. Data were extracted and grouped based on study focus and outcome. Safety incidents were meta-analysed where possible using a random-effects model.ResultsOf the 57 637 article titles and abstracts, 364 met inclusion criteria. Included publications came from 31 countries and included data from over 150 000 participants. Study quality varied and statistical heterogeneity was high. Ten research categories were identified: interpersonal violence, coercive interventions, safety culture, harm to self, safety of the physical environment, medication safety, unauthorised leave, clinical decision making, falls and infection prevention and control.ConclusionsPatient safety in inpatient mental health settings is under-researched in comparison to other non-mental health inpatient settings. Findings demonstrate that inpatient mental health settings pose unique challenges for patient safety, which require investment in research, policy development, and translation into clinical practice.PROSPERO registration numberCRD42016034057.

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“…The practice of restraint and attempts to reduce its use by alternative methods have been attempted in various clinical settings such as (a) acute psychiatry ward,[ 4 7 ] (b) long stay homes for mentally retarded and patients suffering from severe and chronic mental illness, (c) child psychiatry wards,[ 8 ] and (d) elderly care nursing homes. [ 7 ] Restraint in acute psychiatry ward is predominantly used as a means to control aggression and in turn decrease the harm to self and others,[ 9 10 11 ] whereas in child psychiatry wards and long-stay homes, it is used to control problem behaviors. [ 8 ] It is used in elderly nursing homes as a means to decrease the mobility of the patient so as to ease the process of care and to decrease the injuries to self.…”

Section: Types Of Restraintsmentioning

confidence: 99%