Impact of legislative amendment on the use of seclusion and restraint in psychiatry: a French mirror-image study.

Abstract

Introduction: A legislative amendment regarding seclusion and restraint in psychiatry was enacted in France in 2020, aligning with global efforts to reduce coercive measures in mental health care. This study aimed to evaluate whether the amendment was associated with a change in these clinical practices.

Methods: A single-centre, mirror-image observational study was conducted, analysing data from hospitalised patients subjected to seclusion and/or restraint between May 2018 and September 2023. Sociodemographic and clinical data were compared for patients before and after the legislative change.

Results: The study included 126 patients, with 77 requiring both seclusion and restraint. Results indicated no significant effect of the amendment on the frequency of seclusion (p = .7) or restraint (p = .7). Similarly, no differences were observed in the duration of seclusion (p = .4) or restraint (p = .6). Sociodemographic and clinical characteristics remained consistent between the two periods.

Conclusion: The findings suggest that the legislative amendment was not associated with a change in practices. This highlights the need for complementary strategies such as staff training, institutional initiatives, and resource allocation to effectively reduce coercive measures. Further multicentric and longitudinal studies are recommended to assess the broader and long-term impacts of the law.