Underaged patients' opinions toward different containment measures: a questionnaire survey in Finnish adolescent psychiatry.

Problem: The current literature does not provide an understanding of adolescent patients' opinions toward various containment measures and how these are related to the opinions of the staff who are caring for them.

Methods: The study population comprised 81 inpatients and 128 staff members in an inpatient setting in Finland. Their opinions were studied using the Attitude to Containment Measures Questionnaire.

Findings: The adolescents were more critical toward most containment measures compared to the staff. Exactly as reported in previous studies among adult service users, the containment measures most accepted by the adolescents were as-needed medication, intermittent observation, and time out. They were considered as helpful, safe, and respectful methods. Net bed, which has never been used in Finland, was most disapproved. It was considered as a distressing, inhuman, and cruel method. Opinions toward mechanical restraint, which is commonly used in Finnish adolescent psychiatry, were noticeable: adolescents rated mechanical restraint among the three least accepted, staff among the three most accepted containment methods. Adolescents considered it as distressing and not consistent of human dignity.

Conclusions: Adolescents disapprove of containment measures some of which are widely used in psychiatric practice. Their opinions differ significantly from those of the staff. New ways to manage crisis situations should be developed. Where containment cannot be avoided, information, explanation about the procedures involved, and debriefing should be offered to an underaged patient in a manner which takes account of his/her developmental level.