Seclusion in the Netherlands




                   STUIF
         www.defredommissegroep.nl
This introduction is about …

1. Seclusion in Dutch law.
2. The practice of seclusion, facts
and figures.
3. Policies to r...
Definition of Seclusion
            (Lendemeijer & Shortridge-Bagget 1997)




Locking a patient alone in a room for:

 * ...
Definitions




            STUIF
  www.defredommissegroep.nl
STUIF
www.defredommissegroep.nl
Characteristics of the law

Compared with international documents:
• The law has very strict criteria.
• Is basically an a...
Seclusion in the law
• The use of seclusion is allowed in order to
  avert danger for the patient or for others,
  resulti...
2. The practice of seclusion
On average:
- 27,5% of the patients, admitted to a
  psychiatric hospital, is secluded;
- est...
International comparison
Number of separated patients per 1000 admissions (preliminary results
                     (Noort...
International comparison
                preliminary results (Janssen et al. 2008)



Country                             ...
Conclusion
In the Netherlands patients are secluded
  more often than in other countries but the
  seclusions do not evide...
Predictors of seclusion
• Age;
• Disorder on axis 1(bipolar and psychotic
  disorder) and axis 5 (level of functioning);
•...
BUT!!!!
• Differences in numbers of seclusion
  between hospitals in the Netherlands are
  large.
• Registration is not ve...
3. Policies to reduce the use of
       seclusion and restraint

POLICY STAGES


I. Before 2002 no policy


II. 2002-2004 ...
What do these 42 projects do?
• The advancement of competence and expertise.
• Changing wards cultures (welcoming policies...
Upcoming SlideShare
Loading in …5
×

Seclusion In The Netherlands [Compatibiliteitsmodus]

379 views

Published on

Seclusion in NL

0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
379
On SlideShare
0
From Embeds
0
Number of Embeds
5
Actions
Shares
0
Downloads
0
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Seclusion In The Netherlands [Compatibiliteitsmodus]

  1. 1. Seclusion in the Netherlands STUIF www.defredommissegroep.nl
  2. 2. This introduction is about … 1. Seclusion in Dutch law. 2. The practice of seclusion, facts and figures. 3. Policies to reduce the use of seclusion. STUIF www.defredommissegroep.nl
  3. 3. Definition of Seclusion (Lendemeijer & Shortridge-Bagget 1997) Locking a patient alone in a room for: * protection of the patient and his environment; * in order to control problem behaviour; * to enable nursing care and treatment. STUIF www.defredommissegroep.nl
  4. 4. Definitions STUIF www.defredommissegroep.nl
  5. 5. STUIF www.defredommissegroep.nl
  6. 6. Characteristics of the law Compared with international documents: • The law has very strict criteria. • Is basically an admission law. Forced treatment of patients outside the hospital is difficult to realize. • No evaluation of forced treatment as a regular procedure. STUIF www.defredommissegroep.nl
  7. 7. Seclusion in the law • The use of seclusion is allowed in order to avert danger for the patient or for others, resulting from the psyciatric illness. • Seclusion can be applied as part of an agreed upon treatment program (voluntarily) or forced (no agreement, emergency or coercion). STUIF www.defredommissegroep.nl
  8. 8. 2. The practice of seclusion On average: - 27,5% of the patients, admitted to a psychiatric hospital, is secluded; - estimated 500 seclusion rooms/cells in the Netherlands; - estimated 18.000 seclusions every year. STUIF www.defredommissegroep.nl
  9. 9. International comparison Number of separated patients per 1000 admissions (preliminary results (Noorthoorn et al. 2008) 300 250 Australia 200 England Finland 150 Germany 100 Netherlands Switzerland 50 0 STUIF www.defredommissegroep.nl
  10. 10. International comparison preliminary results (Janssen et al. 2008) Country Days in seclusion per 1000 nursing days Belgium Average of 5 Netherlands Average 3,7 United States Between 4-110 STUIF www.defredommissegroep.nl
  11. 11. Conclusion In the Netherlands patients are secluded more often than in other countries but the seclusions do not evidently last longer than in other countries. STUIF www.defredommissegroep.nl
  12. 12. Predictors of seclusion • Age; • Disorder on axis 1(bipolar and psychotic disorder) and axis 5 (level of functioning); • Duration of admittance (longer, more chance); • Days after admittance (shorter, more chance). • Estimate of 50% of seclusions are preceded by agression incidents and vice versa (50% of the agression incidents are followed by a seclusion). STUIF www.defredommissegroep.nl
  13. 13. BUT!!!! • Differences in numbers of seclusion between hospitals in the Netherlands are large. • Registration is not very reliable yet. • Comparison is difficult (registration base is sometimes a ward, sometimes a hospital). • Estimated 30-40% of all the freedom limiting measures is registered (Landeweer et al, 2007). STUIF www.defredommissegroep.nl
  14. 14. 3. Policies to reduce the use of seclusion and restraint POLICY STAGES I. Before 2002 no policy II. 2002-2004 Moving the field (12 projects) III. 2004-2008 Spreading best practice nation wide (42 projects) STUIF www.defredommissegroep.nl
  15. 15. What do these 42 projects do? • The advancement of competence and expertise. • Changing wards cultures (welcoming policies, develop alternatives for seclusion). • Prevention • Intensify dialogue with clients about treatment. • Improve registration. STUIF www.defredommissegroep.nl

×