Reducing the use of coercive measures in inpatient child and adolescent mental health services (CAMHS) requires an understanding of current rates and associated factors. We conducted a systematic review of research published between Jan 1, 2010, and Jan 10, 2024, addressing rates and risk factors for mechanical, physical, or pharmacological restraint, seclusion, or forced tube feeding in inpatient CAMHS. We identified 30 studies (including 39 027 patients or admissions) with low risk of bias. Median prevalence was 17·5% for any coercive measure, 27·7% for any restraint, and 6·0% for seclusion. Younger age, male sex, ethnicity or race other than White, longer stay, and repeated admissions were frequently linked to coercive measure use. Variable rates and conflicting risk factors suggest that patient traits alone are unlikely to determine coercive measure use. More research, especially in the form of nationwide studies, is needed to elucidate the impact of care and staff factors. Finally, we propose reporting guidelines to improve comparisons over time and settings.

中文翻译：

---

住院儿童和青少年心理健康服务中使用强制措施的发生率和危险因素：系统评价和叙述综合


减少住院儿童和青少年心理健康服务 （CAMHS） 中强制措施的使用需要了解当前的比率和相关因素。我们对 2010 年 1 月 1 日至 2024 年 1 月 10 日期间发表的研究进行了系统评价，解决了住院 CAMHS 中机械、物理或药物约束、隔离或强制管饲的发生率和风险因素。我们确定了 30 项低偏倚风险的研究（包括 39 027 名患者或入院患者）。任何强制性措施的中位患病率为 17·5%，任何约束的中位患病率为 27·7%，隔离的中位患病率为 6·0%。年龄较小、男性、种族或白人以外的种族、住院时间较长和重复入院通常与强制措施的使用有关。可变的比率和相互冲突的风险因素表明，仅凭患者特征不太可能决定强制措施的使用。需要更多的研究，特别是以全国性研究的形式，来阐明护理和工作人员因素的影响。最后，我们提出了报告指南，以改进随时间和设置的比较。