Staff attitudes and perceptions towards the use of coercive measures in psychiatric patients

Abstract

The failure of efforts to significantly reduce the use of physical coercive measures (PCMs) in psychiatric hospitals remains a global concern. There is a gap in the understanding of staff's characteristics that may affect their attitudes and perceptions towards PCMs. This study used a cross-sectional design to examine the attitudes and perceptions of staff working at a mental health centre in Israel regarding the use of PCMs and to explore whether staff attitudes differed depending on their professional and demographic background. This study also sought to explore staff willingness to accept a policy of reducing the use of PCMs. The data were collected from 149 staff members (nurses, physicians, and auxiliary staff) working at mental health centre, using a questionnaire developed for this study. The findings indicate a low degree of support for use of PCMs among participants who were older, female, more qualified psychiatric nurses, with longer duration of employment, and those who have not participated in coercive intervention in the past year. The majority of the sample reported a low willingness to reduce the use of PCMs, and a lack of institutional support after participating in a coercive event. High hospital occupancy and insufficient staffing were perceived as contributing factors to coercive incidents. Therefore, availability of trained and experienced staff, elimination of organizational barriers, along with creating and maintaining a safe clinical environment should be a priority. Alternative non-coercive interventions should further be taught and used for managing aggressive and violent behaviour in the psychiatric clinical settings.

Keywords: attitudes; coercion; physical restraint; psychiatry; seclusion.