Patients' preferences for seclusion or forced medication in acute psychiatric emergency in the Netherlands

Psychiatr Serv. 2008 Feb;59(2):209-11. doi: 10.1176/ps.2008.59.2.209.


Objectives: This study examined patients' preferences for coercive measures in case of emergency situations on acute psychiatric wards.

Methods: From November 2004 until January 2006, 104 adult patients completed a questionnaire after they underwent seclusion, nonconsensual medication, or both on one of three acute psychiatric wards in the Netherlands.

Results: Equal numbers of patients preferred seclusion and medication, and both measures were equal in perceived aversiveness and perceived efficacy. Men more often than women expressed a preference for seclusion. Patients who understood why the measure was necessary and acquiesced to it retrospectively held more positive views of the efficacy of the measure.

Conclusions: Many patients on acute psychiatric wards have a clear preference between seclusion and medication. Patients appreciated receiving explanations of the reasons for the use of a restrictive measure and discussing their preferences with staff.

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Attitude to Health
  • Coercion*
  • Emergency Services, Psychiatric / methods*
  • Female
  • Humans
  • Inpatients / psychology
  • Inpatients / statistics & numerical data
  • Male
  • Mental Disorders / drug therapy*
  • Middle Aged
  • Netherlands
  • Patient Isolation / psychology*
  • Patient Satisfaction / statistics & numerical data*
  • Prospective Studies
  • Psychiatric Department, Hospital
  • Sex Distribution
  • Surveys and Questionnaires