Perceived intrusiveness of coercive measures: a Danish survey of mental health service users

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Two distinct clusters emerged separating generally more intrusive and less intrusive coercive measures.
Seclusion and mechanical restraint were rated most intrusive; constant observation, time-out and chemical restraint rated least intrusive.
Female, younger, and participants with prior coercive experience rated all interventions as more intrusive, informing clinical and policy decisions.

Nord J Psychiatry. 2026 May 27:1-10. doi: 10.1080/08039488.2026.2670367. Online ahead of print.

ABSTRACT

INTRODUCTION: Coercive measures (CM) are commonly used in mental health care. From a mental health service user perspective, CM are often associated with physical and psychological harm and a serious infringement on personal autonomy. Danish health legislation, therefore, adheres to principles requiring the use of the least intrusive CM. However, limited knowledge exists about service users’ perceptions of what constitutes the least intrusive CM.

PURPOSE: To survey mental health service users’ perceptions of intrusiveness related to various CM and to identify which interventions they consider the least intrusive.

METHODS: A cross-sectional survey was conducted, which was developed in consultation with mental health service users, inspired by previous international research. Perceived intrusiveness was rated on a 0-10 visual analogue scale (VAS). Data were analysed descriptively and statistically using non-parametric tests.

RESULTS: Of 8,250 eligible participants, 1,367 (16.6%) completed the survey. Ratings revealed two clusters: constant observation, time-out, and chemical restraint were perceived as less intrusive, while seclusion and mechanical restraint (belt alone or with straps) were rated as more intrusive. Female participants, younger participants, and those who have prior CM experience consistently rated all interventions as more intrusive.

CONCLUSION: Rather than identifying a single most or least intrusive measure, the findings suggest a broader distinction between types of CM. Two clusters emerged-those generally perceived as more intrusive and those perceived as less so. This pattern may inform future clinical decision-making and policy development, highlighting the need for further research into subjective, modifiable factors that shape service users lived experiences.

PMID:42201326 | DOI:10.1080/08039488.2026.2670367

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