Contextual factors influencing the use of coercive measures in Portuguese mental health care.

Journal: International journal of law and psychiatry

Volume: 90

Issue: 

Year of Publication: 2023

Affiliated Institutions:  Lisbon Institute of Global Mental Health, Lisbon, Portugal; Comprehensive Health Research Centre (chrc), NOVA Medical School, NOVA University of Lisbon, Lisbon, Portugal; Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria Nsukka, Nigeria. Electronic address: do.aluh@ensp.unl.pt. Lisbon Institute of Global Mental Health, Lisbon, Portugal; Comprehensive Health Research Centre (chrc), NOVA Medical School, NOVA University of Lisbon, Lisbon, Portugal. Serviço de Psiquiatria e Saúde Mental de Adultos, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal; Nova Medical School, Lisbon, Portugal. Department of Mental Health, Unidade Local de Saúde do Baixo Alentejo, Beja, Portugal. Unidade de Internamento do Serviço de Psiquiatria e Saúde Mental de Adultos - Departamento de Saúde Mental do Hospital Professor Doutor Fernando Fonseca. Centro Hospitalar De Vila Nova De Gaia/Espinho, E.P.E.| V. N. Gaia/Espinho Hospital Centre.

Abstract summary 

The use of coercive measures in mental health care is an important indicator of the quality of care being provided, and non-patient-related factors are increasingly recognized to contribute to their use. The study aimed to explore the perspectives of mental health care professionals who have first-hand experience with the use of coercion on the contextual factors that influence the use of coercion in the Portuguese mental health care. Five focus group discussions were conducted among 23 doctors and 17 nurses from five psychiatric departments in urban and rural regions of Portugal. Discussions were audio recorded, transcribed, and analyzed with the aid of MAXQDA. Four broad themes related to insufficient resources, staff-related factors, inefficient services, and socio-legal factors were derived. Participants highlighted how inadequate structures, staff shortages, staff attitudes, a lack of training, restrictive ward rules, an inefficient organization of services, the mental health legislation, and public attitudes contributed to the use of coercive measures. The COVID-19 pandemic complicated existing shortfalls in the system and increased the use of coercive measures. The study confirms that the use of coercive measures in mental health care is influenced by factors that are independent of patient characteristics. Addressing existing systemic problems is crucial for the successful implementation of interventions to reduce coercion in mental health care.

Authors & Co-authors:  Aluh Deborah Oyine DO Santos-Dias Margarida M Silva Manuela M Pedrosa Barbara B Grigaitė Ugnė U Silva Ricardo Caetano RC de Almeida Mousinho Maria Ferreira MF Antunes João Paulo JP Remelhe Mariana M Cardoso Graça G Caldas-de-Almeida José Miguel JM

Study Outcome 

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Statistics
Citations : 
Authors :  11
Identifiers
Doi : 10.1016/j.ijlp.2023.101918
SSN : 1873-6386
Study Population
Male,Female
Mesh Terms
Humans
Other Terms
Coercion;Contextual factor;Involuntary admission;Portugal;Restraint
Study Design
Cross Sectional Study
Study Approach
Systemic Review
Country of Study
Publication Country
Netherlands