Open Hospital Settings Reduce Coercion and Forced Medication


A 2-year, longitudinal study of 2,838 patients finds that a change of treatment policy from “closed” to “open-ward” treatment reduced the use of coercive measures, seclusion, and forced medication, whereas forced medication increased on wards that remained closed. “The decrease in seclusions on newly opened wards remained statistically significant after controlling for diagnoses and severity of illness,” conclude the authors, “Open ward treatment was successfully implemented and was associated with a significant decrease of coercive measures in our study. It might therefore provide a good care model, strengthening the patient’s right to autonomy and leading to a reduction of coercive measures.”

Jungfer, H., Schneeberger, A., Borgwardt, S., Walter, M., et al; Reduction of Seclusion on a Hospital-Wide Level: Successful Implementation of a Less Restrictive Policy. Journal of Psychiatric Research. Online April 1, 2014.

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Kermit Cole
Kermit Cole, MFT, founding editor of Mad in America, works in Santa Fe, New Mexico as a couples and family therapist. Inspired by Open Dialogue, he works as part of a team and consults with couples and families that have members identified as patients. His work in residential treatment — largely with severely traumatized and/or "psychotic" clients — led to an appreciation of the power and beauty of systemic philosophy and practice, as the alternative to the prevailing focus on individual pathology. A former film-maker, he has undergraduate and master's degrees in psychology from Harvard University, as well as an MFT degree from the Council for Relationships in Philadelphia. He is a doctoral candidate with the Taos Institute and the Free University of Brussels. You can reach him at [email protected].