Seattle University Collaborative Projects - International Academy of ...

sessions based on Solution Focused Therapy. In the first two sites taking part in the trial 32patients and their key workers were allocated to DIALOG or to treatment as usual. Every monthfor a period of 6 months, service users met with their key workers to rate their satisfaction withquality of life and treatment and to identify the areas where they needed additional help. Theirresponses were displayed on the screen, compared with previous ratings and discussed. Theprimary outcome measure was quality of life. In this presentation preliminary findings from thefirst two sites participating in the study will be examined. The implications of presented resultsin relation to use of quality of life as an outcome measure will be discussed.142. Reduction of Coercive Measures in PsychiatryDevelopment of a Nationwide Benchmark: Findings from Five Years ofResearchE.O. Noorthoorn (E.noorthoorn@ggnet.nl)W.A. Janssen,G.A.M Widdershoven,H.L.I. Nijman,A. Smit enC.L. MulderBackground: From 2006 onwards the Dutch Government provided funding for Dutch MentalHealth institutions to reduce seclusion by 10% a year. To evaluate the effects of severalinitiatives, the Dutch case register on coercive measures was developed. This register currentlycontains information on the use of coercion from all closed psychiatric wards in the Netherlands.Goal: To develop a Nationwide Benchmark on the use of coercion, allowing corrections onseveral confounders and factors influencing outcome. Methods and Materials: Data on the use ofcoercive measures were collected by nurses at the wards and were compared to the number ofbeds. Patient, team and ward characteristics were taken into account. Multilevel analyses wereperformed to determine the associations between these factors and the use of coercive measures.Results: Results were obtained from 33 large mental health trusts and 8 psychiatric wards locatedwithin a general hospital. The sample contained more than 450 wards covering 95% of all bedsfor involuntarily admitted patients. We found that some hospitals met the goals of a 10%reduction in seclusion rates, while others did not. Between hospitals and wards a tenfoldvariation in the chance of being secluded was observed. Multilevel analyses showed that only asmall part of the variance could be explained by the factors mentioned above. Conclusion: Bygathering coercion data in a central nationwide database, it is possible to compare mental healthtrusts with respect to the use of coercion. Patient, team, and ward characteristics only partlyexplain differences in the use of coercion.336