Coercive measures in psychiatry and patient rights

Mjere prisile pod kojima podrazumijevamo prisilnu hospitalizaciju, prisilnu medikaciju, sputavanje i izolaciju, prisutne su u psihijatriji od njenih začetaka. Iako nose mnoge moralne i etičke dileme, još se koriste u zbrinjavanju pacijenata s akutnim psihijatrijskim stanjima u kojima pacijenti predstavljaju prijetnju sebi ili drugim osobama. Budući da se mjere prisile sve više gledaju kao osjetljivo bioetičko problematiziranje i pitanje ljudskih prava, stoga se, osim zakonskim reguliranjem same mogućnosti uporabe mjera prisile i načina na koji ih se može primjenjivati, pravilnicima pokušavaju uvesti tehnike poput deeskalacije koje bi mogle smanjiti njihovu uporabu. Permanentna bi se edukacija osoblja o usvajanju tih tehnika trebala provoditi ne samo kao moralna, etička i profesionalna obveza, nego i kao zakonski zahtjev u Republici Hrvatskoj.Coercive measures, which include involuntary hospital admission, involuntary medication, restraint and seclusion, have been used in psychiatry since it’s beginning. Although those measures come with serious moral and ethical dilemmas, they are still used in management of patient with acute psychiatric illness when patients represent a danger to themselves or to other people. Considering the coercive measures are more then ever seen as a bioethical problem and have come into the focus of sensitive human rights issue,, besides established legal framework for the use of coercive measures, the experts are trying to introduce techniques like deescalation to minimise their use. Permanenet staff education of learning of those techniques ishoul dnot just be moral, ethical and professional obligation, but as also a legal obligation in Croatia

Coercive measures in psychiatry and patient rights

Mjere prisile pod kojima podrazumijevamo prisilnu hospitalizaciju, prisilnu medikaciju, sputavanje i izolaciju, prisutne su u psihijatriji od njenih začetaka. Iako nose mnoge moralne i etičke dileme, još se koriste u zbrinjavanju pacijenata s akutnim psihijatrijskim stanjima u kojima pacijenti predstavljaju prijetnju sebi ili drugim osobama. Budući da se mjere prisile sve više gledaju kao osjetljivo bioetičko problematiziranje i pitanje ljudskih prava, stoga se, osim zakonskim reguliranjem same mogućnosti uporabe mjera prisile i načina na koji ih se može primjenjivati, pravilnicima pokušavaju uvesti tehnike poput deeskalacije koje bi mogle smanjiti njihovu uporabu. Permanentna bi se edukacija osoblja o usvajanju tih tehnika trebala provoditi ne samo kao moralna, etička i profesionalna obveza, nego i kao zakonski zahtjev u Republici Hrvatskoj.Coercive measures, which include involuntary hospital admission, involuntary medication, restraint and seclusion, have been used in psychiatry since it’s beginning. Although those measures come with serious moral and ethical dilemmas, they are still used in management of patient with acute psychiatric illness when patients represent a danger to themselves or to other people. Considering the coercive measures are more then ever seen as a bioethical problem and have come into the focus of sensitive human rights issue,, besides established legal framework for the use of coercive measures, the experts are trying to introduce techniques like deescalation to minimise their use. Permanenet staff education of learning of those techniques ishoul dnot just be moral, ethical and professional obligation, but as also a legal obligation in Croatia

Parental involvement in the war in Croatia 1991-1995 and suicidality in Croatian male adolescents

Aim To investigate the association between parental war involvement and different indicators of psychosocial distress in a community sample of early adolescents ten years after the war in Croatia 1991-1995. Methods A total of 695 adolescents were screened with a self-report questionnaire assessing parental war involvement, sociodemographic characteristics, and alcohol and drug consumption. Personality traits were assessed with the Junior Eysenck Personality Questionnaire; depressive symptoms with the Children’s Depression Inventory (CDI); and unintentional injuries, physical fighting, and bullying with the World Health Organization survey Health Behavior in School-aged Children. Suicidal ideation was assessed with three dichotomous items. Suicidal attempts were assessed with one dichotomous item. Results Out of 348 boys and 347 girls who were included in the analysis, 57.7% had at least one veteran parent. Male children of war veterans had higher rates of unintentional injuries (odds ratio [OR], 1.2; 95% confidence interval [CI], 0.56 to 2.63) and more frequent affirmative responses across the full suicidal spectrum (thoughts about death – OR, 2.1; 95% CI, 1.02 to 4.3; thoughts about suicide – OR, 5; 95% CI, 1.72 to 14.66; suicide attempts – OR, 3.6; 95% CI, 1.03 to 12.67). In boys, thoughts about suicide and unintentional injuries were associated with parental war involvement even after logistic regression. However, girls were less likely to be affected by parental war involvement, and only exhibited signs of psychopathology on the CDI total score. Conclusion Parental war involvement was associated with negative psychosocial sequels for male children. This relationship is possibly mediated by some kind of identification or secondary traumatization. Suicidality and unintentional injuries are nonspecific markers for a broad range of psychosocial distresses, which is why the suggested target group for preventive interventions should be veteran parents as vectors of this distress

Coercive measures in psychiatry and patient rights

Mjere prisile pod kojima podrazumijevamo prisilnu hospitalizaciju, prisilnu medikaciju, sputavanje i izolaciju, prisutne su u psihijatriji od njenih začetaka. Iako nose mnoge moralne i etičke dileme, još se koriste u zbrinjavanju pacijenata s akutnim psihijatrijskim stanjima u kojima pacijenti predstavljaju prijetnju sebi ili drugim osobama. Budući da se mjere prisile sve više gledaju kao osjetljivo bioetičko problematiziranje i pitanje ljudskih prava, stoga se, osim zakonskim reguliranjem same mogućnosti uporabe mjera prisile i načina na koji ih se može primjenjivati, pravilnicima pokušavaju uvesti tehnike poput deeskalacije koje bi mogle smanjiti njihovu uporabu. Permanentna bi se edukacija osoblja o usvajanju tih tehnika trebala provoditi ne samo kao moralna, etička i profesionalna obveza, nego i kao zakonski zahtjev u Republici Hrvatskoj.Coercive measures, which include involuntary hospital admission, involuntary medication, restraint and seclusion, have been used in psychiatry since it’s beginning. Although those measures come with serious moral and ethical dilemmas, they are still used in management of patient with acute psychiatric illness when patients represent a danger to themselves or to other people. Considering the coercive measures are more then ever seen as a bioethical problem and have come into the focus of sensitive human rights issue,, besides established legal framework for the use of coercive measures, the experts are trying to introduce techniques like deescalation to minimise their use. Permanenet staff education of learning of those techniques ishoul dnot just be moral, ethical and professional obligation, but as also a legal obligation in Croatia