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Coerced medication used in psychiatric care despite lack of clinical evidence
Date:12/4/2008

ent CM. But although half the researchers interviewed patients about their views on receiving CM, they didn't ask them whether they perceived themselves to be a risk to their self or others at the time when CM was administered.

"The studies showed that patients experienced a range of negative feelings when they received CM, including fear, embarrassment, anger and helplessness. Despite this, many said that they retrospectively agreed with the practice."

Research papers included in the review showed a notable lack of detailed exploration into the events leading up to the CM incidents and a complete absence of investigation into alternatives.

"This may reflect variations in the way conflict is managed in inpatients settings in different countries" suggests Jarrett. "CM is more likely to be used in the UK than in other countries, in which other forms of restraint such as seclusion or physical restraint are employed. Previous research by Professor Bowers showed that in some countries, such as the Netherlands, injecting someone against their will is seen as a serious violation of the body, yet the use of mechanical restraints is acceptable."

Jarrett and colleagues conclude that their review has highlighted a lack of clinical evidence on which to base CM, pointing out that the practice may discourage people from seeking help from, and engaging with, mental health services.

"Earlier and more effective interventions might be useful in minimising the use of CM, while better training in skills such as de-escalation strategies might also be valuable in avoiding coercion" says Jarrett.

The authors also feel that more research is needed into the use of CM.

"While there has been a lot of research into the pharmacological effectiveness of particular medications for quick and effective sedation, the reasons for the compulsory administration of powerful sedative and neuroleptic drugs have not been scrutinised clo
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Contact: Annette Whibley
wizard.media@virgin.net
Wiley-Blackwell
Source:Eurekalert

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