Page 17 - Reduction of coercive measures

that coercive measures should only be used as a last resort after less intrusive alternatives have been examined. Coercive measures are therefore always to be subjected to scrutiny, as new alternatives may be developed and tried. In addition, the harm that is avoided by coercive measures may not always outweigh the physical and emotional harm that is caused by the coercive measures themselves (Heyvaert et al., 2015).
In the Netherlands, the Psychiatric Hospitals (Compulsory Admissions) Act (Wet Bopz) from 1992 regulates the enforcement of these rights. The law describes a series of measures that may be applied without consideration of the consent of the persons subject to these measures to prevent or avert danger. Also, the law sets out a number of criteria which have to be met when applying coercive measures. In 2020 this law is succeeded by the Care and Coercion Act (Staatsblad 2018, 36), which tightens up criteria under which a care provider may intervene without permission in the life of a client. This act will apply a broad interpretation of coercive care, which includes any measure which a care organization’s clients or their legal representatives object or resist against. Organizations will have to adapt their policies to the new act, including the maintenance of a current record of coercive measures and multidisciplinary decision- making on the level of individual residents. The present study took place in the context of these shifts in the legal protection of people with intellectual disabilities with regard to the registration of coercive measures by support staff and professionals.
Care without coercive measures
The use of coercive measures is an issue in all forms of care for people with disabilities. Nevertheless, the question of how to find a solution for the reduction of coercive measures seems to be the most complex and urgent in facilities where 24/7- care is provided (Bowring, Totsika, Hastings, Toogood, & Griffith, 2017; Cooper et al., 2009). In residential care multiple persons with disabilities live in group homes. The daily care is carried out by a team of support staff and is characterized by rules, written care plans, and limits to the amount of individual attention. In addition, residential care is sought when less intensive
General introduction
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