The effects of a nationwide program to reduce seclusion in the Netherlands

<p>Abstract</p> <p>Background</p> <p>From 2006 to 2009, the Dutch government provided €5 m annually for a nationwide program to reduce seclusion in psychiatric hospitals by 10% a year. We aimed to establish whether the numbers of both seclusion and involuntary medicatio...

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Main Authors: Vruwink Fleur J, Mulder Cornelis L, Noorthoorn Eric O, Uitenbroek Daan, Nijman Henk LI
Format: Article
Language:English
Published: BMC 2012-12-01
Series:BMC Psychiatry
Subjects:
Online Access:http://www.biomedcentral.com/1471-244X/12/231
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spelling doaj-2f38f27cbc9340dfbb2bfd81e36bef0c2020-11-25T00:37:54ZengBMCBMC Psychiatry1471-244X2012-12-0112123110.1186/1471-244X-12-231The effects of a nationwide program to reduce seclusion in the NetherlandsVruwink Fleur JMulder Cornelis LNoorthoorn Eric OUitenbroek DaanNijman Henk LI<p>Abstract</p> <p>Background</p> <p>From 2006 to 2009, the Dutch government provided €5 m annually for a nationwide program to reduce seclusion in psychiatric hospitals by 10% a year. We aimed to establish whether the numbers of both seclusion and involuntary medication changed significantly after the start of this national program.</p> <p>Methods</p> <p>Using Poisson regression to estimate difference in logit slopes, we analyzed data for 1998–2009 from the Dutch Health Care Inspectorate, retrospectively examining the national numbers of seclusion and involuntary medication before and after the start of the program.</p> <p>Results</p> <p>The difference in slopes of the numbers of seclusion before and after the start of the program was statistically significant (difference 5.2%: p < 0.001). After the start of the program seclusions dropped 2.0% per year. Corrected for the increasing number of involuntary hospitalizations this figure was 4.7% per year. The difference in slopes of the numbers of involuntary medication did not change statistically significant (difference 0.5%, n.s.). After correction for the increasing number of involuntary hospitalizations the difference turned significant (difference 3.3%, p = 0.002).</p> <p>Conclusions</p> <p>After the start of the nationwide program the number of seclusions fell, and although significantly changing, the reduction was modest and failed to meet the objective of a 10% annual decrease. The number of involuntary medications did not change; instead, after correction for the number of involuntary hospitalizations, it increased.</p> http://www.biomedcentral.com/1471-244X/12/231SeclusionRestraintCoercive measuresReductionNationwide effort
collection DOAJ
language English
format Article
sources DOAJ
author Vruwink Fleur J
Mulder Cornelis L
Noorthoorn Eric O
Uitenbroek Daan
Nijman Henk LI
spellingShingle Vruwink Fleur J
Mulder Cornelis L
Noorthoorn Eric O
Uitenbroek Daan
Nijman Henk LI
The effects of a nationwide program to reduce seclusion in the Netherlands
BMC Psychiatry
Seclusion
Restraint
Coercive measures
Reduction
Nationwide effort
author_facet Vruwink Fleur J
Mulder Cornelis L
Noorthoorn Eric O
Uitenbroek Daan
Nijman Henk LI
author_sort Vruwink Fleur J
title The effects of a nationwide program to reduce seclusion in the Netherlands
title_short The effects of a nationwide program to reduce seclusion in the Netherlands
title_full The effects of a nationwide program to reduce seclusion in the Netherlands
title_fullStr The effects of a nationwide program to reduce seclusion in the Netherlands
title_full_unstemmed The effects of a nationwide program to reduce seclusion in the Netherlands
title_sort effects of a nationwide program to reduce seclusion in the netherlands
publisher BMC
series BMC Psychiatry
issn 1471-244X
publishDate 2012-12-01
description <p>Abstract</p> <p>Background</p> <p>From 2006 to 2009, the Dutch government provided €5 m annually for a nationwide program to reduce seclusion in psychiatric hospitals by 10% a year. We aimed to establish whether the numbers of both seclusion and involuntary medication changed significantly after the start of this national program.</p> <p>Methods</p> <p>Using Poisson regression to estimate difference in logit slopes, we analyzed data for 1998–2009 from the Dutch Health Care Inspectorate, retrospectively examining the national numbers of seclusion and involuntary medication before and after the start of the program.</p> <p>Results</p> <p>The difference in slopes of the numbers of seclusion before and after the start of the program was statistically significant (difference 5.2%: p < 0.001). After the start of the program seclusions dropped 2.0% per year. Corrected for the increasing number of involuntary hospitalizations this figure was 4.7% per year. The difference in slopes of the numbers of involuntary medication did not change statistically significant (difference 0.5%, n.s.). After correction for the increasing number of involuntary hospitalizations the difference turned significant (difference 3.3%, p = 0.002).</p> <p>Conclusions</p> <p>After the start of the nationwide program the number of seclusions fell, and although significantly changing, the reduction was modest and failed to meet the objective of a 10% annual decrease. The number of involuntary medications did not change; instead, after correction for the number of involuntary hospitalizations, it increased.</p>
topic Seclusion
Restraint
Coercive measures
Reduction
Nationwide effort
url http://www.biomedcentral.com/1471-244X/12/231
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