Being admitted to an inpatient Child and Adolescent Mental Health Service (CAMHS) as a child or young person (CYP) can be distressing, often as a last resort when community support has failed. CAMHS services treat those with serious mental health issues, such as suicide risk or violent behavior. It is crucial to provide support before crisis point to prevent coercive measures like restraint or seclusion. Recently, studies have highlighted the need to understand and reduce the use of coercive practices in CAMHS settings. Researchers have conducted a systematic review to analyze rates and risk factors for coercive measures in inpatient CAMHS care, aiming to minimize their use and improve patient outcomes.
The study included 30 papers with varied rates of coercive measures use, especially in units treating eating disorders. Sociodemographic and patient-related factors were major predictors of coercion, with younger age, male sex, non-White ethnicity, and aggression being significant. Care-related factors like extended stay and repeated admissions also played a role in coercive practices. The review identified the need for standardized definitions and measurements related to coercive practices to facilitate comparison across settings.
The systematic review highlighted the persistent reliance on coercive measures in some settings, emphasizing the importance of ongoing efforts to minimize their use in child and adolescent psychiatric care. More research is needed to explore the impact of care and staff factors on coercion. Ultimately, the goal is to avoid the use of coercive practices in children and implement interventions to reduce their use, particularly in mental health settings.
