It is not possible to determine whether the data presented
here indicate better or worse clinical practice in Swiss versus
German hospitals. Research is needed to analyse to
what extent the use of different kinds of coercive measures,
the reapplication and the duration of coercive measures
are associated with psychological traumatisation of
patients and the security of staff. Objectives for further
research are to obtain comparable figures on the use of
compulsory measures in routine psychiatric care across
different countries. The working groups have helped to
coordinate data collection across countries and efforts are
currently being made to collect the same data in Wales.
The continuous surveillance of key indicators will show
possible effects of changes in health care policy, admission
policy, staffing levels and treatment guidelines on the
use of coercive measures in clinical practice. Beyond all
methodological difficulties, comparisons across countries
give an external point of reference and allow critical reflection
of national traditions. They allow for knowledge
transfer and help to achieve transparency on an international
level. The preconditions of such international comparisons
are uniformed definitions and reliable
documentation of coercive measures as well as an identical
way of data analysis. To meet these conditions is the
first step to achieve European standards for the use of
coercive measures.