Rapid tranquillisation use in adult mental health inpatient settings: an analysis of Danish complaints

Abstract

Rapid tranquillisation (RT) is a commonly used restrictive practice in mental health; however, reducing its use has been a longstanding international priority. In this context, addressing potential unlawful RT use may be a crucial starting point for improving mental health care practices. We aimed to explore changes over time in RT use in adult mental health inpatient settings from the perspective of the Danish Psychiatric Patient Complaints Board and Appeals Board. We included all published board reports from 2018 to 2023, reviewed available material and extracted information related to RT complaints. Descriptive statistics and content analysis were applied. RT use was involved in 20.2% of all decisions on average. While the number of decisions increased modestly, the proportion of overturned RT-related decisions decreased substantially. Across 56 identified cases involving 74 episodes, RT was frequently deemed unlawful due to factors such as insufficient documentation of de-escalation attempts or inconsistencies in medication. Over the period, approvals were more likely if the clinical situation was well described in the medical record. Although legal criteria remained unchanged, the interpretation and application appear to have evolved, reflecting greater sensitivity to complex situations. Further research is needed to deepen understanding of how RT and related complaint outcomes change over time.