In 2016, the Finnish National Institute for Health and Welfare published a working paper to help ‘hospitals and wards providing involuntary psychiatric care to reduce the use of coercion against patients and to increase occupational and patient safety’ (Makkonen et al., 2016, p.6). The Finnish language workbook outlines ways to ensure the ‘patient's sovereignty is respected as much as possible’ within the law and includes ‘operating models for the prevention of coercive measures, based on research evidence and solid practical experience’ (Makkonen et al., 2016, p.6). The practices are: the Six Core Strategies (discussed above), the ‘application of psychiatric patient intent, and assessment methods of violence risk,’ methods of preventing seclusion and restraint, and the Safewards model.
According to the authors, ‘[a]ll levels of psychiatric care and treatment systems play an important role in reducing coercive measures’ (Makkonen et al., 2016, p.6). Further:
The workbook describes the importance of versatile outpatient care in reducing coercive measures. The expertise and attitudes of hospital staff in addition to the care culture and space solutions are in a major role in reducing coercive measures and increasing safety. The workbook presents concrete solutions to improve staff expertise and to promote the application of a care culture that reduces the need for coercion. The photos show how the minimalistic environment of the isolation room has been made more humane at relatively low cost. Based on the stories of people who have been involved with coercion, readers have a chance of getting some idea of how patients subjected to it feel. Coercion should not be reduced at the expense of occupational and patient safety. Both of these viewpoints are described in the last chapter. Reducing coercion is a continuous process, and hopefully this workbook will have a sequel in the form of a cookbook-style guide in reducing coercion.
No materials concerning the success of the initiative, or the relative rates of coercion before and after the publication of the workbook were identified.