Space for youth mental health-coercive measure use before and after architectural innovation at a department of child and adolescent psychiatry.

Autor: Czernin K; Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria., Bründlmayer A; Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria., Baumgartner JS; Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria., Plener PL; Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria.; Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany.
Jazyk: angličtina
Zdroj: Child and adolescent mental health [Child Adolesc Ment Health] 2024 Nov; Vol. 29 (4), pp. 333-339. Date of Electronic Publication: 2023 Dec 12.
DOI: 10.1111/camh.12690
Abstrakt: Background: Influence of architectural features in child and adolescent psychiatric wards on coercive measure use has not been investigated so far. We aimed to assess the effect of altering the physical environment of an adolescent psychiatric inpatient unit on the proportion and frequency of adolescents experiencing mechanical coercive measures.
Method: In a naturalistic observational design, coercive measures were compared before and after an architectural intervention facilitated by rebuilding a child and adolescent psychiatric department in October 2020. Age, gender, length of stay, main psychiatric diagnosis and indices of coercion in n = 782 admissions to inpatient child and adolescent psychiatry from April 2019 to April 2022 were extracted. Group comparisons were performed using chi-squared tests for categorical and Mann-Whitney U-tests for numerical variables.
Results: After structural modernization which included amplifying space and with the newly introduced availability of seclusion rooms, significantly fewer patients were affected by mechanical restraint (8.1% vs. 13.7%, p = .013). Rate of seclusion increased to 5.0% (vs. 0%, p < .001). Rate of seclusion and/or restraint decreased from 13.7% to 11.8% (p = .425). The median cumulative duration of all coercive measures per affected case decreased significantly (2.8 vs. 5.4 h, p = .005), as well as its proportion to length of stay (0.8% vs. 2.8%, p = .006).
Conclusions: Modernisation and restructuring of buildings hosting psychiatric departments can contribute to a reduction of coercive measures in child and adolescent psychiatric units.
(© 2023 The Authors. Child and Adolescent Mental Health published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.)
Databáze: MEDLINE
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