Investigating the impact of coercion prevention initiatives in an adolescent psychiatric ward.

Purpose: In adolescent psychiatric wards, various interventions have been implemented to reduce the incidence of restrictive practices. These interventions are less studied than in adult psychiatry and the impact often remains unclear. To investigate the significance of the initiatives implemented in an adolescent ward, an explorative retrospective study was performed.

Material and methods: Information about initiatives to reduce the use of restrictive practices was collected from documents on the ward from 2015 to 2022. During this period, the incidence of restrictive interventions was recorded in the region's electronic register. Information on initiatives and incidences of restrictive interventions was compared using descriptive statistics and incidence rates.

Results: In the study period, twenty different initiatives were initiated on the ward. None of the interventions led to a sustained decrease in the number of coercive episodes. However, some of them appeared to reduce the incidence of restrictive interventions temporarily, such as de-escalation courses and Safewards. During the first winter of the COVID-19 pandemic (2020/2021), a high rate of restrictive interventions was observed, coinciding with the cancellation of many ward activities.

Conclusion: Although none of the initiatives implemented led to a permanent reduction in restrictive interventions, the temporary decreases observed following some of the initiatives suggest that increased awareness may have had an effect. This emphasises the necessity for sustained focus on an intervention if the impact is to be maintained.