Page 128 - Reduction of coercive measures

Chapter 6
the possibility of variable awareness among support staff members of coercive measures and high level of difficulty of identifying coercive measures within the complex context of long-term group care for people with often severe and multiple disabilities. The final part of the study showed the success of the implementation of a mandatory routine registration system by comparing registration of coercive measures to residents’ care records. Agreement was conditional on the registration of coercive measures in the registration system. 84% coercive measures were identified and talked through during training and agreement was reached on 46% of coercive measures. In conclusion it has become clear that a routine and adequate registration of the use of coercive measures is feasible, at least for a subset of coercive measures.
Legal criteria for registration considered in more detail.
Registration of coercive measures is a leading and mandatory component of the Dutch Care and Coercion Act (Staatsblad, 2018, 36), which will enter into force in 2020. Mandatory registration is one of the reasons why the introduction of this Act will have far-reaching consequences for professional care for people with intellectual disabilities. The Act sets out criteria for the identification and registration of coercive measures and thus contributes to better legal protection for people with intellectual disabilities (Frederiks & Steen, 2018). Chapter three described a viewpoint that is based on reflections by experts with broad scientific and practical knowledge in the field of care for people with intellectual disabilities. Experts focused on the criteria set by law, the description of categories of care practices which should be registered, and the way in which registration would be influenced by environmental and other factors.
Unclear definitions of coercive measures may explain (Matson & Boisjoli, 2009; Webber et al., 2011) low reliability of data on the use of coercive measures, limiting the utility of these data to monitor, test and, if necessary, adjust coercive practices. Also in the Netherlands there is a great deal of confusion and discussion about the concept of coercive measures. The current Psychiatric Hospital Act (Wet Bopz) does not provide a definition of coercive measures, but lists a number
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