Coercion in Psychiatry: Exploring the Subjective Experience of Coercion Among Patients in Five Portuguese Psychiatric Departments.

Journal: The journal of behavioral health services & research

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Affiliated Institutions:  Lisbon Institute of Global Mental Health, Lisbon, Portugal. aluhdeborah@yahoo.com. Department of Quantitative Methods, Universidad Loyola Andalusia, Seville, Spain. NOVA Medical School, NOVA University of Lisbon, Lisbon, Portugal. Unidade de Internamento Do Serviço de Psiquiatria E Saúde Mental de Adultos - Departamento de Saúde Mental Do Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal. Lisbon Institute of Global Mental Health, Lisbon, Portugal. Serviço de Psiquiatria E Saúde Mental de Adultos, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal.

Abstract summary 

The subjective experience of coercion may have a more significant impact on clinical outcomes than formal coercive measures. This study aimed to investigate the subjective experience of coercion among patients on admission in Portuguese psychiatric departments by assessing their perceived coercion, procedural justice, and negative pressures during admission. The study also investigated whether this subjective experience of coercion changed with time during admission, and the predictors of this change. Validated instruments, including the McArthur Admission Experience Survey (AES) and the Client Assessment of Treatment Scale, were used to collect information from 208 adults admitted to five public psychiatric inpatient departments in rural and urban regions of Portugal. About a third (32.24%, n = 49) of the sample had a legal involuntary admission status, while more than a third of them perceived their admission to be involuntary (40.13%, n = 61). The subjective experience of coercion was significantly higher among people who perceived their admission to be involuntary compared to people who perceived their admission to be voluntary (Median = 10, IQR = 5.5 vs. Median = 3, IQR = 6; p < 0.001). Satisfaction with their care was significantly inversely correlated with the subjective experience of coercion (p < 0.01). The changes in the subjective experience of coercion at the second assessment were predicted by the perceived admission status rather than the legal admission status, and the initial procedural justice (p < 0.05). The study findings highlight the importance of improving procedural justice in psychiatric admissions, regardless of the legal status of admission.

Authors & Co-authors:  Aluh Deborah Oyine DO Diaz-Milanes Diego D Azeredo-Lopes Sofia S Barbosa Sofia S Santos-Dias Margarida M Silva Manuela M Grigaitė Ugnė U Pedrosa Barbara B Velosa Ana A Cardoso Graça G Caldas-de-Almeida José Miguel JM

Study Outcome 

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Citations :  Herrman H, Allan J, Galderisi S, et al. Alternatives to coercion in mental health care: WPA position statement and call to action. World Psychiatry. 2022;21(1):159–160. Available at https://doi.org/10.1002/wps.20950 . Accessed 9 May, 2024.
Authors :  11
Identifiers
Doi : 10.1007/s11414-024-09890-7
SSN : 1556-3308
Study Population
Male,Female
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Publication Country
United States