[Compulsory procedures at the Psychiatric Department, Frederiksberg Hospital, before and after introduction of the new psychiatric legislation. 3. Compulsory medication]. / Tvang udføort på psykiatrisk afdeling, Frederiksberg Hospital, før og efter indførelsen af den nye psykiatrilov. 3. Tvangsmedicinering.

The purpose of this investigation was to register if the new Danish law concerning commitment and compulsory procedures in psychiatry from 1.10.1989 caused changes in the extent of forced medications. During the period: 1.1.1988-30.9.1991 all compulsory procedures in the department of psychiatry, Frederiksberg Hospital, were registered. The number of patients medicated by force was unchanged, but after the law reform significantly fewer patients were medicated with depotpreparations and the duration of forced medication was significant longer. Twenty-three patients complained about the forced medication, one before and 22 after the law reform. For 18 patients the complaints put off administration of the forced medication, and they waited a total of 251 days for the complaints board to make a decision. The complaints board only agreed with one patient. The law reform has increased the public security for the psychiatric patients but did not as intended prevent or limit forced medication.

[Compulsory admissions to Frederiksberg Hospital after introduction of the new psychiatric legislation compared with the period just before the change of the law]. / Tvangsindlaeggelse på Frederiksberg Hospital efter den nye psykiatrilovs indførelse sammenlignet med perioden umiddelbart før lovaendringen.

The new Danish Act on confinement and other means of compulsion in psychiatry came into force October 1st, 1989. To investigate changes connected with the new act all involuntary commitments to the psychiatric department of the hospital of Frederiksberg, with a catchment area of 85,000 inhabitants, were prospectively registered during 23 months before, 25 months after the new legislation. Information about the commitment was obtained from the admission papers and the case records. The patients were asked to participate in an interview. Both before and after the new act there were about 35 commitments per year. There was a trend towards an increasing number of women being committed by reason of threat to the patient's health after the new act. No significant changes were observed regarding age, condition at admission, diagnoses, duration of hospitalization or condition at discharge. A little more than half of the committed patients participated in the interviews. The new act stressed the rights of the patients. In spite of this the patients did not express any increase in their understanding of or satisfaction with their hospitalization.

[Use of restraints in a psychiatric department, Frederiksberg Hospital, before and after introduction of the new psychiatric law. Restraining devices]. / Tvang udført på psykiatrisk afdeling, Frederiksberg Hospital, før og efter indførelsen af den ny psykiatrilov. Tvangsfikseringer.

The purpose of this investigation was to register if the new Danish law concerning commitment and compulsory procedures in psychiatry from 1.10.1989 caused changes in the use of restraints. During the period 1.2.1988-30.9.1991 all compulsory procedures in the Department of Psychiatry, Frederiksberg Hospital, were registered. A total of 145 patients were restrained during 167 admissions. No changes were registered in the number of restraints in connection with the law reform, but the duration of the fixations increased by 42%. The number of medications given forcibly in connection with the restraints increased significantly. One of the purposes of the the law reform was to reduce the number and duration of restraints. This purpose has not been fulfilled.

[Use of alternative treatment among hospital staff in a psychiatric and a rheumatology department]. / Brug af alternativ behandling blandt personalet ved en psykiatrisk og en fysiurgisk afdeling.

Staff members of a psychiatry and a rheumatology department were given a questionnaire concerning their use of alternative treatment. The response rate was 59% (111 of 187). Of 111 replies it was found that 48% had used alternative treatment at least once, while 23% had used alternative treatment within the 3 months preceding the interview. There were no significant differences in the use of alternative treatment in relation to sex or age. Only 22 had paid more than 1000 Dkr. for alternative treatment during their lifetime. The personnel's total expenses for alternative treatment within the last 3 months were 10,400 Dkr. paid by 19 members of the personnel. Compared to investigations of the general population this investigation indicated that the hospital staff had used alternative treatment more widely. Staff use of alternative treatment was at a similar level to that found in different patient group. If the way in which the staff relates to illness and treatment serves as a model for others, it cannot be expected that they counteract the use of alternative treatment.

[Compulsory procedures in the psychiatric department, Frederiksberg Hospital, before and after introduction of the new psychiatric legislation]. / Tvang udført på psykiatrisk afdeling, Frederiksberg Hospital, før og efter indførelse af den nye psykiatrilov.

Registration of compulsory procedures in a psychiatric department before and after the reform of the Danish law concerning commitment and compulsory procedures in psychiatry. The purpose of this investigation was to register if the law reform 01.10.1989 caused changes in the extent of compulsory procedures in a psychiatric department. The study was prospective. During the period: 01.02.1988-30.09.1991, all compulsory procedures in the department of psychiatry, Frederiksberg Hospital, were registered. A total of 289 patients had been subjected to compulsory procedures during 336 admissions. The compulsory procedures registered were: incarceration in the department, forced medication and restraint by a belt. The total number of admissions with compulsory procedures increased after the law reform. The number of incarcerations increased. No changes were registered in the number of restraints and forced medications in connection with the law reform but, two years after, increases of 37% and 74% respectively were registered. One of the main purposes of the law reform was to limit and, if possible, to prevent compulsory procedures. This purpose has not been fulfilled. The increase in the extent of compulsory procedures in the latter part of the observation period is probably caused by factors such as increase bed occupancy and decrease in resources.

[Alternative forms of treatment of psychiatric patients]. / Psykiatriske patienters brug af alternativ behandling.

In the Psychiatric Department of Frederiksberg Hospital, 115 of all 153 admitted patients were interviewed about their use of alternative treatment. Information obtained from the interviews was compared with data in the case records. Of the 115 patients interviewed, 42% had used alternative treatment at least once, while 17% had used alternative treatment within the past three months before the interview. Herbal medicine was the most frequent type of treatment. Nearly one half of the patients wanted treatment because of somatic problems. The frequency of alternative treatment decreased with age. Compared to the entire investigation group, those diagnosed as manic-depressive used alternative treatment more frequently, while schizophrenic patients used this kind of treatment less often. The patients most satisfied with the psychiatric department used alternative treatment less frequently. Use of alternative treatment was not related to duration of disease, or whether the patients were in the ward 24 hours or only during day-time. Only 19 of the 48 patients who had used alternative treatment had paid more than 1,000 Dkr. (approximately pounds 85) in all for the treatment, and only three patients had paid more than 1,000 Dkr. during the past three months. Women had paid relatively more for their treatment than men.

[Access to case records at the County Hospital in Vordingborg]. / Journalindsigt på Amtshospitalet i Vordingborg.

During 1987, all requests for access to case records at the Psychiatric Hospital in Vordingborg were registered prospectively. Fifty-nine patients made a total of 69 requests for access to case records. The total time used by the staff in connection with the requests was 51 hours and 47 minutes. Of all the patients admitted to the hospital in 1987 only 3.7% asked for access to case records. No serious problems in relation to this were registered. There was a significant tendency for the younger patients, the patients with non-psychotic disorders, and especially patients with borderline disorders to ask for access to their records more frequently.