Scholarlink

<p>Evidence on legislative reforms to reduce coercive measures remains limited. We evaluated short-to-medium-term effects of Sweden’s July 2020 stricter legal regulation of coercive measures in youth &lt; 18 years. In a controlled interrupted time-series study, we used 2017–2021 registry and electronic medical record data from inpatient child and adolescent mental health services (CAMHS) in Region Stockholm, Sweden. Controls included Finnish CAMHS and Region Stockholm young adult psychiatric patients (18–24 years). Monthly outcomes were rates of seclusion, mechanical restraint, involuntary medication and a composite measure, mean durations, and sedative medication use. Segmented regression estimated level- and trend changes, adjusting for pre-intervention trends. Among 7,075 admissions (3,840 individuals) to Stockholm inpatient CAMHS, involuntary medication <i>increased</i> immediately in minors relative to young adults (incidence rate ratio 2.49, 95% CI 1.63–3.81), with no other changes in patient-day-standardised models. Comparisons with Finnish CAHMS provided no consistent evidence of reduced coercion. Mean durations also increased in minors versus young adults (12% for seclusion; 6% for mechanical restraint), while sedative medication use remained stable. Findings were robust in sensitivity analyses. Contrary to the reform’s aims, stricter legislation alone was not associated with reduced coercive measure use.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Impact of legislative reform on coercive measure use in child and adolescent psychiatry: A controlled interrupted time series analysis

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年5月18日

查看全文
  • Astrid Moell,
  • Erik Pettersson,
  • Riittakerttu Kaltiala,
  • Niklas Långström

摘要

Evidence on legislative reforms to reduce coercive measures remains limited. We evaluated short-to-medium-term effects of Sweden’s July 2020 stricter legal regulation of coercive measures in youth < 18 years. In a controlled interrupted time-series study, we used 2017–2021 registry and electronic medical record data from inpatient child and adolescent mental health services (CAMHS) in Region Stockholm, Sweden. Controls included Finnish CAMHS and Region Stockholm young adult psychiatric patients (18–24 years). Monthly outcomes were rates of seclusion, mechanical restraint, involuntary medication and a composite measure, mean durations, and sedative medication use. Segmented regression estimated level- and trend changes, adjusting for pre-intervention trends. Among 7,075 admissions (3,840 individuals) to Stockholm inpatient CAMHS, involuntary medication increased immediately in minors relative to young adults (incidence rate ratio 2.49, 95% CI 1.63–3.81), with no other changes in patient-day-standardised models. Comparisons with Finnish CAHMS provided no consistent evidence of reduced coercion. Mean durations also increased in minors versus young adults (12% for seclusion; 6% for mechanical restraint), while sedative medication use remained stable. Findings were robust in sensitivity analyses. Contrary to the reform’s aims, stricter legislation alone was not associated with reduced coercive measure use.