The involuntary treatment of adolescent psychiatric inpatients—A nation‐wide survey from Finland

Abstract

This national cross‐sectional study investigates the prevalence rates, regional differences and factors associated with the involuntary inpatient treatment of adolescents in Finland on a chosen day in 2000. The proportion of inpatients with involuntary legal status was 29.5% (n=82) giving a prevalence rate of 2.5 per 10,000/12–17 years old inhabitants.Forty‐eight per cent of involuntarily inpatients were 16–17 years old and 62% had psychotic disorders. Twenty‐six per cent of inpatients with involuntary legal status were voluntarily admitted. Regional differences of involuntary treatment were rather modest. Psychotic disorders, suicidal acts, and substance use disorders were independently associated with involuntary legal status.There is a need for further studies to investigate the long‐term effects of involuntary treatment on the adolescents’ subsequent well‐being. Further studies on alternatives methods for involuntary treatment are warranted, likewise the clinical guidelines for involuntary treatment practices.

Attitudes towards different containment measures: a questionnaire survey in Finnish adolescent psychiatry

“…This finding might stem from high rates of involuntary treatment and legal detention in the Finnish adolescent psychiatric system (Kaltiala‐Heino 2004, Siponen et al . 2007, Ellilä et al . 2008).…”

“…Many in the field of adolescent psychiatry consider the use of containment measures to manage aggression in underage patients controversial (Bath 1994, Earle & Forquer 1995, Mesham 1995, Sourander et al . 2002, Ellilä et al . 2008).…”

‘It's unbelievably humiliating’—Patients' expressions of negative effects of coercion in mental health care

“…There is also a risk that some adolescent patients lack or lose trust in parents and staff during hospitalization, and consequently feel isolated in the ward. Given frequent use of coercion, the potential for informal coercion, and the vulnerable adolescent years, perceived coercion in adolescents should be an important research topic [9].…”

A cross-sectional study of experienced coercion in adolescent mental health inpatients

“…Some prospective studies have connected experienced coercion to lower quality of life [ 12 ], and worse alliance and follow up of care [ 13 ], but a review found small or absent effects on variables such as psychosocial functioning, readmissions, or service engagement [ 14 ]. Given frequent use of formal coercion, the potential for informal pressure or coercion, and the vulnerable adolescent years, experienced coercion in adolescents should be an important research topic [ 15 ].…”