Coercive measures in psychiatry remain a contentious issue in both medical and legal debates, particularly in relation to patients’ rights and personal freedom. A new study commissioned by Luxembourg’s Ombudsman Claudia Monti has shed light on what she describes as the excessive and inconsistent use of such measures in psychiatric care across the country.
Speaking to RTL, Monti stressed that interventions like physical restraints should always be a last resort.
The study focused on child and adolescent psychiatry and was conducted over the last two years by the Ombudsman’s office, which oversees places where individuals’ liberties are restricted. Collaborating with a German expert, the investigation reviewed treatment practices in several psychiatric institutions.
The conclusion was clear: significant action is needed.
Among the concerning findings were cases where children had been wrapped tightly in blankets to prevent movement. Such restraining techniques, Monti noted, should only be used under exceptional circumstances.
She explained that these methods can be particularly distressing for young or vulnerable patients, especially when no proper explanation is given. Many patients struggle to understand why such force is being used, making the experience even more traumatic, according to Monti.
The ombudsman further highlighted the broader issue of inconsistent practices, stating that each clinic currently applies coercive measures according to its own discretion. She explained that there is no national framework to standardise their use, with the documentation surrounding such incidents often incomplete and alternative approaches rarely not even considered.
This lack of oversight creates potential for misuse, she emphasised.
Monti pointed out that in some clinics, staff can decide to use a coercive measure first, with a doctor only validating it afterward – or sometimes only if specifically requested. This, she warned, opens the door to abuse. In her view, the absence of clear rules makes it easier for coercive interventions to become routine rather than exceptional.
To address the issue, Monti has recommended the creation of standardised legal regulations applicable to all psychiatric institutions. She also called for better documentation, as well as more structured communication between medical staff and patients. Her aim is to prevent coercive measures from becoming normalised and to ensure they remain an absolute last resort.
