The use and registration of coercion in psychiatry in the new millennium.

Introduction: The Danish Mental Health Act of 1989 emphasized that the use of coercion should be recorded. The National Board of Health has published statistics on this issue since 1990. This study investigates the use of coercive measures at all Danish psychiatric departments from 1990 to 1998. Material and methods: The official statistics published by The National Board of Health was collected and analyzed. Results: There was an increase in the use of forced medication and mechanical restraint. No increase was found in the use of involuntary commitment or detention. Discussion: Some of the increase found as regards forced medication and mechanical restraint could be due to problems in recording the correct number of episodes. The Mental Health Act does not take into account problems concerning elderly with dementia. Extralegal coercion or hidden coercion can take place outside a psychiatric ward, for instance in nursing homes or somatic departments. More empirical studies in this area are needed before the decision to record extralegal coercion is taken.