Characteristics of direct coercion use in paediatric psychiatry ward
Marcin Mikusek-Pham Van1, Patrycja Niedziółka-Trębacz1,2

Introduction and objective: Direct coercion is used in psychiatry as a last resort method to control a patient who behaves in an auto- or allo-aggressive manner, in a situation when other measures have failed. The aim of the study was to analyse coercive measures applied in child psychiatry wards with regard to patient-related and institution-related factors. Materials and methods: A retrospective analysis of 153 direct coercive measures applied from 26 March 2023 to 18 March 2024 in an inpatient child psychiatry department with a total of 20 beds. Results: In the one-year period covered by this study, 368 patients were admitted to the ward; 31 of them (8.42%) were under direct coercion in a total of 153 situations. The most commonly applied form of coercion was isolation – 93 times (42.66%). Doctors applied coercive measures 104 times (67.97%), while nurses – 49 times (32.03%). Overall, the median duration of direct coercion was 65 minutes. The median duration of direct coercion at day shifts was significantly longer in comparison to night shifts. Direct coercion was used in almost 70% of cases in children diagnosed with autism spectrum disorder. Conclusions: The therapeutic dynamics in paediatric psychiatry is unique to its field. Despite the same legal regulations, the characteristics of coercive measures in child psychiatry differ from the data reported for adult patients.