From the results of a protocol study on the use of restraint medhods for patients who may do socially dangerous acts dne to mental illness

Abstract

Introduction: The use of restraint methods by psychiatrists dates back more than 300 years, and since the Middle Ages, mechanical methods of restraining patients have been used under the name of “mechanized psychotherapy.” In 1792, the French scientist P. Pinel proposed that psychiatrists use the mildest method without the use of mechanical methods. Mongolia has introduced a system of non-discrimination against the mentally ill since 1935, and the Mental Health Law of 2000 legalized the methods to restrain the mental patients. According to the WHO (2005) study, Mongolia is on the list of countries where there are no reports of involuntary hospitalization or use of restraint. Therefore this study is being conducted to investigate the possibilities to implement protocol to record the every performance of restraint methods and to clarify the recent situation of usage of restriction methods. Goal: The purpose is to keep a record of the use of restraint methods for patients who may do socially dangerous acts due to mental illness and to evaluate the results. Ethics of the study: The research is based on the ethical approval of the NCMH (December 2, 2019 2 1/930) and on the consent of Research Ethics Committee of the MNUMS (June 12, 2020 № 2020/3 -05). Methods and techniques: The research team developed and used a 24-question protocol to record the use of restraint methods in inpatients at the NCMH. Research results: The protocols were recorded for 74 patients who were likely to engage in socially dangerous activities due to mental illness. The patients treated with restraint methods were aged between 2 to 68 years and 48 (64.8%) were male (p = 0.008), which were statistically significant. 87.8% of the patients were from Ulaanbaatar. Patients with psychosis and depression were the most likely to engage in socially dangerous activities. The use of restraint was recommended by the attending physician in 66.2% and by the doctor on duty in 33.8% (n = 25). Discussion: It is hoped that a legal framework that can be used nationwide will be established once the restraint method protocol has been developed and officially ratified. № Conclusion: In the future, it is considered important to protect the rights of mentally ill patients by improving the protocol of “Recording the use of restraint methods” in accordance with international requirements and introducing it into daily activities.