Work

Utilisation of coercive measures in involuntary patients admitted to two psychiatric hospitals in KwaZulu-Natal, South Africa

Year: 2026

Type: article

Abstract: Background: There is a high prevalence of involuntary psychiatric admissions in South Africa, with literature on the measures used to coerce patients into care being limited. Aim: This study aimed to quantify the coercive measures that were used during involuntary admissions to two psychiatric hospitals in KwaZulu-Natal province, and to identify factors associated with their use. Setting: King Dinuzulu Hospital Complex in Durban and Townhill Psychiatric Hospital in Pietermaritzburg. Methods: This was a sub-analysis of a cross-sectional, descriptive, quantitative study of involuntarily admitted patients aged 18 years and above. Data were collected through participant interviews at discharge and by extracting information from patients’ clinical records and Mental Health Care Act forms. Results: Of the 131 patients included, 66% were male, 85.5% were single, and 71.4% were unemployed. The prevalence of chemical, mechanical, physical restraint, and seclusion was 73.3%, 14.5%, 24.43%, and 16.8%, respectively, with 38.2% being exposed to more than one method. Significantly more male patients than female patients were physically restrained h(81% vs 19%; p = 0.04), and placed in seclusion (86.4% vs 13.6%; p = 0.05). Except for mechanical restraint, a longer length of hospital stay was significantly associated with the other three coercive measures (p ≤ 0.05). Conclusion: Chemical restraint was the most common method of coercion, with more than one-third of patients being exposed to two or more methods. Contribution: This study highlights the high utilisation of coercive methods and informs the need for reducing their use in psychiatric hospitals in South Africa.

Source: South African Journal of Psychiatry

DOI: 10.4102/sajpsychiatry.v32i0.2603

Authors: Sibongile Mashaphu, Zinhle P. Shozi, Vuyokazi Ntlantsana, Shamima Saloojee

Institution: University of KwaZulu-Natal

Language: English

Topic: Healthcare Decision-Making and Restraints

Subfield: Clinical Psychology

Field: Psychology

Domain: Social Sciences

SDGs: Good health and well-being, Peace, justice, and strong institutions

Open Access status: gold

Estimated APC paid: $562