S 4 Coercion in psychiatry : still an

S156 has been withdrawn because it was submitted forpublication in error without the consent of all the authors. S157The use of seclusion and restraint during15 years – a nationwide study in FinlandAlice Keski-Valkama, Eila Sailas, Markku Eronen,Jouko Lönnqvist and Riittakerttu Kaltiala-HeinoVanha Vaasa Hospital, P.O.Box 13, 65380 Vaasa, Finland BMC Psychiatry 2007, 7(Suppl 1):S157 Background: Internationally, concerns over the use of seclu-sion and restraint in psychiatric care have increased over the pastdecades. In Finland, restriction of freedom and use of coercion inpsychiatry are regulated by the Mental Health Act of 1991. Afterits implementation, the Act (revision 2002) has become morerestrictive and specified in relation to using coercion. Objective:This study investigated the nationwide trends in the use ofseclusion and restraint in Finland over a fifteen-year span(1990–2004) that was characterised by legislative changes.Methods: The data was collected during a predeterminedweek in 1990, 1991, 1994, 1998, and 2004 using the NationalHospital Discharge Register and a structured postal survey ofFinnish psychiatric hospitals.Results: Notwithstanding the legislative changes, the use ofseclusion and restraint did not change in Finland during 15 years.Conclusion: Ethical and clinical considerations are discussed. S158Patients’ view of seclusion – preliminary reportAlice Keski-Valkama, Markku Eronenand Riittakerttu Kaltiala-HeinoVanha Vaasa Hospital, P.O.Box 13, 65380 Vaasa, Finland BMC Psychiatry 2007, 7(Suppl 1):S158 Background: Seclusion, putting a patient involuntarily alone ina locked unfurnished room from which she/he cannot freelyexit, is a prevailing coercive measure in modern psychiatricpractice. In recent years, clinical, ethical, and legal debate hasincreased awareness of its controversial nature. However,studies focused on the views of the secluded patients themselvesare sparse. Objective: To describe a pilot phase of an extensiveresearch project concerning the seclusion experience of 100forensic and civil psychiatric patients.Methods: Secluded patients were interviewed using a semi-structured interview developed for the purpose of this researchproject.Results: Both negative and positive aspects were associatedwith seclusion. Interaction between the secluded patient and thestaff was perceived as insufficient.Conclusion: Clinical implications are discussed.Symposium composed of individual contributions S159The development of a scale to measurestaff attitude to coercionTonje Lossius Husum and Torleif RuudSINTEF Health, PB 124, Blindern, 0314 Oslo, Norway BMC Psychiatry 2007, 7(Suppl 1):S159 Previous studies have shown that there is considerable variationin the degree to which coercion is used in mental healthinstitutions. This variation between institutions and evenbetween wards is seen in many countries. Many factors havebeen put foreword to explain this variation in the use ofcoercion, but we still can’t explain it. If we had a betterunderstanding of these factors, we would know more abouthow the use of coercion can be reduced in mental health care.Measures of coercion in this study are amount of involuntaryadmissions, forced medications and use of restraints (bed-belts)on Norwegian acute-wards. Some of the factors explored inprevious studies include geography, population size, patientcharacteristics, ward characteristics etc. Staff attitudes to theuse of coercion are one factor that has not yet been investigatedin this regard. The scope of this project is first to develop aquestionnaire to measure staff attitudes to the use of coercion.The next step will be to investigate if differences in staff attitudesto coercion can explain some of the variation in the actual use ofcoercion on wards in the mental health service. The project willalso deliver updated dataabout how much coercion is used onNorwegian acute-wards in 2005/2006. This project is part of abig multi-center study on many aspects on Norwegian acute-wards (MAP). S160Mass culture of coercive psychiatric confinementAnthony ChaseNova Southeastern University Law Center, 3305 CollegeAvenue, Fort Lauderdale, FL 33314, USA BMC Psychiatry 2007, 7(Suppl 1):S160 In Movies on Trial [1], I examine ways in which popular legalculture (especially television, fiction, and film) helps shapeAmerican attitudes toward different aspects of legal processand legal system. Among the topics I consider are criminal law,tort law, international law, constitutional law, and comparativelaw. I am now writing a second book on this subject, Movies onAppeal, and I will be examining a second tier of legal topics orsubjects (contract law, property law, the law of war, labor law)and how they are treated in mass culture. Specifically, I will beadding a chapter on law and psychiatry, a course which I havetaught to law students for about 20 years. I wish to examinethe ways in which popular legal culture helps to shape images(and perceptions) of coercive psychiatric confinement in theUnited States. Perhaps no other issue in the field of law andpsychiatry has captured public attention or the focus of massBMC Psychiatry 2007, 7(Suppl 1)http://www.biomedcentral.com/1471-244X/7?issue=S1