Introduction:Various forms of coercion are used in the psychiatric care of patients with self-injurious behaviors, but there is little research on how these are perceived by the patients. The aim of this study was to investigate how 6 patients, who had received care for self-injurious behavior, perceived coercion and how they think coercion could be avoided.Methods:This study employed a qualitative design with 6 semistructured interviews and interpretative phenomenological analysis.Results:Three main themes were identified: keep voluntary care voluntary, apportioning control and responsibility, and dialogue and participation. Constant supervision was described as the most destructive form of coercion. To enable self-responsibility, a reduction of control and supervision was advocated. Calls were made for a treatment based on the assumption that there is a desire, on behalf of the patients, to get better.Conclusions:The use of coercion in the psychiatric care of patients with self-injurious behavior can be reduced by increasing predictability, by listening to the patient with genuine interest, and by involving the patient in decisions regarding their treatment.
Psychological autopsies have been suggested and used for clinical and forensic investigation, as well as for research purposes, in investigation surrounding a completed suicide. While accidental drug overdose death constitutes a major clinical and forensic challenge, psychological autopsy rarely has been mentioned as a potential tool in post mortem investigations of these causes of death. This is in contrast to the high number of established risk factors described in the literature on drug overdose deaths. Consequently, based on the vast literature on overdose risk factors, we here propose the use of psychological autopsies for the investigation of events and circumstances preceding cases of overdose death.
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