Direct physical constraint - realization of Mental Health Protection Act assumptions considering aggresive patients in chosen health institutions of Westpomeranian province

Izabela Kupś, Justyna Pełka-Wysiecka, Jerzy Samochowiec


Introduction. In the past centuries mentally ill patients with aggressive behavior were treated in different ways. In
actual legislation dealing with such patient is determined by the Mental Health Protection Act.

Material and methods. All medical stuff of 10 health care institution was involved in following study. Wards
where the study took place were co-educational. Data from 204 respondents were analyzed. The majority of them
(over 90%) were nurses, 6.9% doctors and 2.9% social care takers.
Time of employment up to 10 years reported 41.7% of respondents, 27.5% were working more than 20 years in
health care institutions. Statistical analyses were done with the use of SPSS. Study was conducted with the use of
questionnaire, containing questions about the use of direct physical constraint. Answers were analyzed in respect
of correct acting of respondents according to regulations of Mental Health Protection Act. Data about the level of
knowledge about specific law regulations among respondents and the incidence of using direct physical constraint
by them were also obtained.

Results. After the analysis we concluded, that aggression among patients occurs in all studied institutions, the
level of knowledge of Mental Health Protection Act regulations depends on institution profile, respondents reported
the use of direct physical constraint, the incidence of direct physical constraint use seems to depend on the
length of employment time, full realization of Mental Health Protection Act regulations in the field of direct
physical constraint use was reported by psychiatry profiled institution stuff only.

Conclusions. Following should be done:

- the necessity of law supervision over the use of direct physical constraint is essential,

- education of non-psychiatric stuff in dealing with aggressive mentally ill patients,

- placing the information about the right procedures in that matter in standards of institution,

- employing the satisfying number of experienced medical stuff.


aggression; direct physical constraint; Mental Health Protection Act
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