Luxembourg calls for a review of violent interventions in psychiatry

A new report initiated by the Luxembourg Ombudsman Claudia Monti sheds light on a controversial and painful topic - coercive measures in psychiatry, especially for children and adolescents. We are talking about physical restraint of patients, restriction of mobility, sometimes isolation. All this affects not only health, but also fundamental human rights: the right to freedom and dignity.

The report cites cases where children have been wrapped tightly in blankets to restrict their movements. These measures, Monty emphasises, can be extremely traumatic - especially in a situation where no one explains to the patient what is happening and why. "For children, it's not just physical restriction. It's a feeling of complete incomprehension and loss of control," the ombudsman notes.

Particularly disturbing was the revelation that every clinic in the country uses coercive measures "at its own discretion". In some places, a doctor intervenes, but only after the fact, and in others, decisions are made by medical staff without consulting a doctor at all. This fragmentation creates a legal vacuum and a risk of systemic abuse.

Documentation of incidents of violence was found to be often superficial or non-existent. And alternative ways of dealing with acute situations are not even considered as an option.

The Ombudsman did not limit herself to criticism - she suggested concrete steps. Among them:

• Introduction of national legislation unifying the rules for the use of coercive measures in all psychiatric institutions.
• Mandatory full documentation of each case.
• Developing communication between medical staff and patients - especially children.

The main goal is to make violent interventions truly the exception rather than a familiar part of the treatment routine.

The problem that Claudia Monti is talking about lies at the boundary between medicine and human rights. Any form of coercion in a therapeutic environment is not only an act of intervention, but also a test of the maturity of the system: is it able to empathise, to explain, to look for other ways? Or does the convenience of the staff once again outweigh the interests of the patient?