Skip to main content

Advertisement

SpringerLink
Log in

Professionals’ Attitudes Toward Reducing Restraint: The Case of Seclusion in The Netherlands

  • Original Research
  • Published:
Psychiatric Quarterly Aims and scope Submit manuscript

Abstract

Introduction

Despite public opinion and policy interventions, restraint remains a common practice. This is also the case in the Netherlands, where projects aimed to reduce seclusion, have not lead to a decreased use of restraint. Is this lack of effectiveness related to attitudes of the professionals? The aim of this study was to explore the attitudes of professionals working in mental health care toward restraint.

Method

A questionnaire with eight scales was constructed for measuring attitudes of professionals. Scores of 540 professionals were studied, using analysis of variance and cluster analysis and related to several personnel and organizational characteristics.

Results

The more professionals were personally involved in seclusion, the more they believed in it. Three types of professionals were identified: Transformers, Doubters and Maintainers. More than half of the psychiatrists (56%) belonged to the type of maintainers. Nurses were more divided.

Conclusion

Professionals working in clinical settings are not really opposed to restraint. This could explain the limited effects of innovation projects.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Harding T: Human rights law in the field of mental health: a critical review. Acta Psychiatrica Scandinavica 101(suppl.399):24–30, 2000

    Article  Google Scholar 

  2. Nelstrop L, Chandler-Oatts J, Bingley W, et al.: A systematic review of the safety and effectiveness of restraint and seclusion as interventions for the short-term management of violence in adult psychiatric inpatient settings and emergency departments. Worldviews on Evidence-Based Nursing 3:8–18, 2006

    Article  PubMed  Google Scholar 

  3. Pollard R, Yanasak E, Rogers S, et al.: Organizational and unit factors contributing to reduction in the use of seclusion and restraint procedures on an acute psychiatric inpatient unit. Psychiatric Quarterly 78:73–81, 2007

    Article  PubMed  Google Scholar 

  4. Janssen W, Hutschemaekers G, Lendemeijer B: Dwang cijfermatig in beeld (Numbers of restraints). In: Abma T, Widdershoven G, Lendemeijer B (Eds) Dwang en drang in de psychiatrie (Restraint and coercion in mental health). Utrecht, Lemma, 2005

    Google Scholar 

  5. Poulsen H, Engberg M: Validation of psychiatric patients’ statements on coercive measures. Acta Psychiatrica Scandinavica 103:60–65, 2001

    Article  PubMed  CAS  Google Scholar 

  6. Bowers L, van der Werf B, Vokkolainen A, et al.: International variation in containment measures for disturbed psychiatric inpatients: A comparative questionnaire survey. International Journal of Nursing Studies 44:357–364, 2007

    Article  PubMed  Google Scholar 

  7. Nijman H, Palmstierna T, Almvik R, et al.: Fifteen years of research with the Staff Observation Aggression Scale: a review. Acta Psychiatrica Scandinavica 111:12–21, 2005

    Article  PubMed  CAS  Google Scholar 

  8. Abma T, Widdershoven G, Lendemeijer B (Eds) Dwang en drang in de psychiatrie (Restraint and coercion in mental health). Utrecht, Lemma, 2005

    Google Scholar 

  9. Dutch Health Care Inspectorate: Jaarbericht 2005 (Annual report 2005) Den Haag, Inspectie voor de volksgezondheid, 2006

  10. Keski-Valkama A, Sailas E, Eronen M, et al.: A 15-year national follow-up: legalisation is not enough to reduce the use of seclusion and restraint. Social Psychiatry and Psychiatric Epidemiology 42:747–752, 2007

    Article  PubMed  Google Scholar 

  11. Sailas E, Wahlbeck K: Restraint and seclusion in psychiatric inpatient wards. Current Opinion in Psychiatry 18:555–559, 2005

    Article  PubMed  Google Scholar 

  12. Meehan T, Bergen H, Fjeldsoe K: Staff and patients perceptions of seclusion: has anything changed? Journal of Advanced Nursing 47:33–38, 2004

    Article  PubMed  Google Scholar 

  13. Salize H, Dressing H: Coercion, involuntary treatment and quality of mental health care: is there any link? Current Opinion in Psychiatry 18:576–584, 2005

    Article  PubMed  Google Scholar 

  14. Griffiths L: Does seclusion have a role to play in modern mental health nursing? British Journal of Nursing 10:656–661, 2001

    PubMed  CAS  Google Scholar 

  15. Heyman E: Seclusion. Journal of Psychosocial Nursing 25:9–12, 1987

    CAS  Google Scholar 

  16. Fisher W: Restraint and seclusion: a review of the literature. American Journal of Psychiatry 151:1584–1591, 1994

    PubMed  CAS  Google Scholar 

  17. Sailas E, Fenton M: Seclusion and restraint for people with serious mental illness. Cochrane Database Syst Rev 1: doi: 10.1002/14651858.CD001163, 2000

  18. Jolliffe I: Principal component analysis, 2nd ed. New York, Springer, 2002

    Google Scholar 

  19. Lind M, Kaltiala-Heino R, Suominen T, et al.: Nurses’ ethical perceptions about coercion. Journal of Psychiatric and Mental Health Nursing 11:379–385, 2004

    Article  PubMed  CAS  Google Scholar 

  20. Olofsson B, Norberg A: Experiences of coercion in psychiatric care as narrated by patients, nurses and physicians. Journal of Advanced Nursing 33:89–97, 2001

    Article  PubMed  CAS  Google Scholar 

  21. Vuckovich D, Artinian B: Justifying coercion. Nursing Ethics 12:370–380, 2005

    Article  PubMed  Google Scholar 

  22. Wynaden D, Orb A, McGowan S, et al.: The use of seclusion in the year 2000: what has changed? Collegian 8:19–25, 2001

    PubMed  CAS  Google Scholar 

  23. Lendemeijer B: Seclusion in psychiatry: aspects of decision making. Utrecht, Academic Dissertation Utrecht University, 2000

    Google Scholar 

  24. Olofsson B, Gilje F, Jacobsson L, et al.: Nurses’ narratives about coercion in psychiatric care. Journal of Advanced Nursing 28:45–53, 1998

    Article  PubMed  CAS  Google Scholar 

  25. Huckshorn K: Reducing seclusion and restraint use in US mental health settings: deep change required…©. Stirling, University of Stirling, 2006. http://www.nm.stir.ac.uk/documents/rftl2006-huckshorn1.pdf

  26. Spijker J, de Ruiter G, de Blok H, et al.: De rol van psychiaters bij separeren (The role of psychiatrists toward seclusion). Maandblad geestelijke volksgezondheid 60:1084–1094, 2005

    Google Scholar 

  27. Callaly T, Minas H: Reflections on clinician leadership and management in mental health. Australasian Psychiatry 13:27–32, 2005

    Article  PubMed  Google Scholar 

  28. Zinkler M, Priebe S: Detention of the mentally ill in Europe—a review. Acta Psychiatrica Scandinavica 106:3–8, 2002

    Article  PubMed  Google Scholar 

  29. Stolker J, Hugenholtz G, Heerdink E, et al.: Seclusion and the use of antipsychotics in hospitalized psychiatric patients. Psychology, Crime & Law 11:489–495, 2005

    Article  Google Scholar 

  30. Allen M, Currier G, Hughes D, et al.: Treatment of behavioral emergencies: a summery of the expert consensus guidelines. Journal of Psychiatric Practice 9:16–38, 2003

    Article  PubMed  Google Scholar 

  31. Citrome L: New treatments for agitation. Psychiatric Quarterly 75:197–213, 2004

    Article  PubMed  Google Scholar 

  32. Davison S: The management of violence in general psychiatry. Advances in Psychiatric Treatment 11:362–370, 2005

    Article  Google Scholar 

  33. Wynn R: Staff’s attitudes to the use of restraint and seclusion in a Norwegian university psychiatric hospital. Nordic Journal of Psychiatry 57:453–459, 2003

    Article  PubMed  Google Scholar 

  34. McCue R, Urcuyo L, Lilu Y, et al.: Reducing restraint use in a public psychiatric inpatient service. Journal of Behavioral Health Services & Research 31:217–225, 2004

    Google Scholar 

  35. Sullivan A, Bezmen J, Barron C, et al.: Reducing restraints: alternatives to restraint on an inpatient psychiatric service—utilizing safe and effective methods to evaluate and treat the violent patient. Psychiatric Quarterly 76:51–65, 2005

    Article  PubMed  Google Scholar 

  36. Fisher W: Elements of successful restraint and seclusion reduction programs and their application in a large, urban, state psychiatric hospital. Journal of Psychiatric Practice 9:7–15, 2003

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Gelderse Roos Research Institute for Professionalization, Wolfheze, The Netherlands

    Marjan van Doeselaar & Giel Hutschemaekers

  2. PO Box 27, Renkum, 6870 AA, The Netherlands

    Marjan van Doeselaar

  3. Department of Education, University of Amsterdam, Amsterdam, The Netherlands

    Peter Sleegers

  4. Department of Clinical Psychology, Radboud University, Nijmegen, The Netherlands

    Giel Hutschemaekers

Authors
  1. Marjan van Doeselaar
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Peter Sleegers
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Giel Hutschemaekers
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Marjan van Doeselaar.

Rights and permissions

Reprints and permissions

About this article

Cite this article

van Doeselaar, M., Sleegers, P. & Hutschemaekers, G. Professionals’ Attitudes Toward Reducing Restraint: The Case of Seclusion in The Netherlands. Psychiatr Q 79, 97–109 (2008). https://doi.org/10.1007/s11126-007-9063-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11126-007-9063-x

Keywords

Search

Navigation