The impact of forced medication in mental health care

Professor Eimear Muir-Cochrane has led a study on the use and impact of chemical (pharmaceutical) restraint in South Australian psychiatric units.

The outcomes of her research are being presented during Flinders Health Research Week on 7 September at 10.45am at Flinders Medical Centre, Lecture Theatre 4.

Coercive measures such as restraint and seclusion are used worldwide in mental health care to manage patients who are deemed a risk to themselves and/or others.

Chemical or pharmaceutical restraint, where patients are forced or coerced to take psychotropic medication, is one such measure.

Chemical restraint has been described as a highly coercive intervention with deleterious emotional and physical outcomes for consumers.

However, in comparison to other containment practices used in psychiatric inpatient settings (mechanical and physical restraint, seclusion), few studies have investigated the prevalence of chemical restraint use, characteristics of patients who are restrained and features of these events.

Professor Muir-Cochrane’s study has explored the perceptions and understandings of health professionals, including nursing, medical and allied health workers, about how chemical restraint is defined and used in adult acute mental health care and emergency departments, as well as the impact of its use.

In collaboration with Dr Adam Gerace and Deb O’Kane from the College of Nursing and Health Sciences, Professor Muir-Cochrane examined the use of chemical restraint across 12 acute inpatient psychiatric units in South Australia over a 12 month period (to June 2016).

This study found that while the incidence of the use of forced medication was relatively low, of those who experienced it, there were more males (57.5%) than females, with over 55% of patients having a diagnosis of schizophrenia.

A greater proportion of patients in the 25-34 year age range were being restrained.

It was found that restraint use occurred early in consumers’ admissions, and events often occurred at staff changeover and consumer medication and meal times.

During the research study semi-structured interviews and focus groups were held with senior representatives from consumer advocacy groups such as Mental Illness Fellowship of SA, SA Health and Community Complaints Commissioner and the Consumer/Carer Register DOH SA to gain broader perspectives about the use of chemical restraint from advocacy groups and the general public.

“The use of forced medication to control a patient’s behaviour must always be used as a last resort but is necessary in emergencies to guarantee the safety of patients and staff,” said Professor Muir-Cochrane.

This research study and several others are being presented as part of Flinders inaugural Health Research Week.

Other highlights of Health Research Week include Better pain relief via microchip, Caring for patients at death’s door, Synergies between art and science and Use of daisies to treat prostate cancer.

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