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The use of seclusion and restraint during 15 years – a nationwide study in Finland


Internationally, concerns over the use of seclusion and restraint in psychiatric care have increased over the past decades. In Finland, restriction of freedom and use of coercion in psychiatry are regulated by the Mental Health Act of 1991. After its implementation, the Act (revision 2002) has become more restrictive and specified in relation to using coercion. Objective: This study investigated the nationwide trends in the use of seclusion and restraint in Finland over a fifteen-year span (1990–2004) that was characterised by legislative changes.


The data was collected during a predetermined week in 1990, 1991, 1994, 1998, and 2004 using the National Hospital Discharge Register and a structured postal survey of Finnish psychiatric hospitals.


Notwithstanding the legislative changes, the use of seclusion and restraint did not change in Finland during 15 years.


Ethical and clinical considerations are discussed.

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Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution 2.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Keski-Valkama, A., Sailas, E., Eronen, M. et al. The use of seclusion and restraint during 15 years – a nationwide study in Finland. BMC Psychiatry 7 (Suppl 1), S157 (2007).

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  • Public Health
  • Mental Health
  • Hospital Discharge
  • Psychiatric Hospital
  • National Hospital