Legal provisions and practice in the management of violent patients. A case vignette study in 16 European countries - 25/02/09

Doi : 10.1016/j.eurpsy.2008.03.002

Tilman Steinert ^a,^⁎ , Peter Lepping ^b
^a Centre for Psychiatry Weissenau, Ulm University, Department of Psychiatric Care Research, Weingartshofer Straße 2, 88214 Ravensburg-Weissenau, Germany
^b North Wales Section of Psychological Medicine, Wrexham Academic Unit, Technology Park, Wrexham, Wales, UK

Corresponding author. Tel.: +49 751 7601 2738; fax: +49 751 7601 2767.

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Abstract

Aim

To compare the clinical management of typical scenarios by using three case vignettes in a substantial number of European countries.

Method

Three case vignettes and an associated questionnaire, filled in and finalised by at least two experts from each country.

Results

Legislation and clinical practice varies widely across the 16 included countries. No specific pattern emerged. Certain practices (intravenous medication, mechanical restraint, net beds and forensic transfers, respectively) only exist in few countries. Legislation for involuntary medication is most restrictive in the Netherlands.

Conclusions

There is little harmonisation and a lack of consistent standards within and across European countries regarding treatment and management of violent patients.

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Keywords : Violence, Medication, Country, Legislation, Restraint, Seclusion