Effects of a Regulatory Protocol for Mechanical Restraint and Coercion in a Spanish Psychiatric Ward



Jose Guzman-Parra DClinPsy Clinical Psychologist, PhD Student, Juan A. Garcia-Sanchez RN Psychiatric Nurse, Isabel Pino-Benitez RN Psychiatric Nurse, Mercedes Alba-Vallejo MD Psychiatrist andFermin Mayoral-Cleries PhD Psychiatrist

Perspectives in Psychiatric Care

October 26, 2014






There is still limited information on what type of measures are most efficient to reduce coercion. The aim of this study was to determine if the introduction of a new regulatory protocol in a specific psychiatric ward in Andalusia (Spain) contributed to reducing the use of mechanical restraint.

Design and Methods

The study included a comparison of two time periods: 2005 (one year before the implementation of the new regulatory protocol) and 2012, in all hospitalized patients (N = 1,094). The study also analyzes with logistic regression the variables related to a shorter duration of mechanical restraint.


Mechanical restraint rate per year was reduced, not significantly, from 18.2% to 15.1%. The average duration of each mechanical restraint episode was significantly reduced from 27.91 to 15.33 hr. The following variables have been associated with a shorter period of coercion: being female and the year of restraint (2012).

Practice Implications

Specific plans are required, including different interventions, in order to achieve marked reduction in the use of coercive measures.









Human Services and Justice Coordinating Committee