04. tbl. 109. árg. 2023

Involuntary medication in psychiatric units at Landspitali University Hospital in the years 2014-2018

Nauðungarlyfjagjafir á geðdeildum Landspítala árin 2014-2018

Eyrún Thorstensen1

Brynjólfur Gauti Jónsson2,3

Helga Bragadóttir4,5

1Mental Health Services Landspitali University Hospital, 2The Icelandic Heart Association, 3Statistician Consulting Center at the School of Health Sciences, University of Iceland, 4Chair Nursing Administration, University of Iceland Faculty of Nursing and Midwifery School of Health Sciences, 5Landspitali University Hospital.

Correspondence: Eyrún Thorstensen, eyruntho@landspitali.is

Key words: mental health services, mental disorder, coercion, psychiatry, hospitals.

INTRODUCTION: Coercion is considered controversial and is criticized around the world. Involuntary medication is one type of coercion, but the extent of its use in Iceland is not well known. The aim of this study is to shed light on the extent and time of involuntary medication in Landspitali University Hospital in Iceland, when it is most often used and whether there is a difference between patients who receive involuntary medication and those who do not receive such treatment.

MATERIAL AND METHODS: This study is a quantitative descriptive retrospective study using data obtained from medical records. The sample consisted of all patients admitted to the psychiatric inpatient wards at Landspitali University Hospital in Iceland in the years 2014-2018 (N=4053). The sample was divided into two groups, group 1 with patients who received involuntary medication n=400 (9.9%) and group 2 with patients who did not receive such treatment n=3653 (90.1%).

RESULTS: The total number of involuntary medications was 2438 and about 1% of the total sample received about half of all involuntary medication. Involuntary medications were most frequent during the daytime during weekdays and late at night, but no notable difference was seen between months of the year. When comparing the groups, it appears that proportionally more men and patients with foreign citizenship are in group 1 than in group 2, but no notable difference is seen in age between groups. Patients in group 1 had more visits to the emergency services at Landspitali, more admissions, and patient days per patient at psychiatric wards in Landspitali than those in group 2. The most common medical diagnosis in group 1 were within the schizophrenia spectrum (F20-F29) and mood disorders (F30-39) but in group 2 the most common medical diagnosis were mental and behavioral disorders due to psychoactive substance use (F10-19) and mood disorders (F30-F39).

CONCLUSION: Findings indicate certain risk factors for involuntary medication regarding demographic, medical diagnosis, use of services as well as external factors such as timing of involuntary medication. A more detailed analysis could be used to reduce the use of coercive treatment. Further research is needed on the use of coercion in psychiatric wards in Iceland.


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