Implementation of the safewards model to reduce the use of coercive measures in adult psychiatric inpatient units: An interrupted time-series analysis

The aim of this study was to investigate whether the implementation of the Safewards model reduces the frequency of coercive measures in adult psychiatric inpatient units. Data on all coercive measures performed in psychiatric hospitals in the Region of Southern Denmark 1/1/2012-31/3/2017 were collected retrospectively through The Register of Coercive Measures in Psychiatric Treatment. Interrupted time series analysis by segmented regressions with poisson models were performed on overall coercive measures (n = 12,660), mechanical restraint (n = 2948) and forced sedation (n = 4373). A 2% (95% CI: 1%-4%, p < 0.001) decrease per quarter in the frequency of coercive measures and an 11% (95% CI: 8%-13%, p < 0.001) decrease per quarter in the frequency of forced sedation were found after the implementation of the Safewards model. In conclusion, the implementation of the Safewards model in adult psychiatric inpatient units was associated with a decrease in forced sedation and potentially the overall use of coercive measures.