Feeling coerced during voluntary and involuntary psychiatric hospitalisation: A review and meta-aggregation of qualitative studies

Silva, Benedetta; Bachelard, Mizue; Amoussou, Joëlle Rosselet; Martinez, Debora; Bonalumi, Charlotte; Bonsack, Charles; Golay, Philippe; Morandi, Stéphane

doi:10.1016/j.heliyon.2023.e13420

Cited by 13 publications

(14 citation statements)

References 117 publications

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“…respectively. There were 28 service user sub-themes, in which we rated overall confidence as high (10), moderate (13), low (3), or very low (2). For the 19 carer sub-themes, we rated overall confidence as high (13), moderate (4), or low (2).…”

Section: Resultsmentioning

confidence: 99%

“…There were 28 service user sub-themes, in which we rated overall confidence as high (10), moderate (13), low (3), or very low (2). For the 19 carer sub-themes, we rated overall confidence as high (13), moderate (4), or low (2). Decisions for lowering confidences were most commonly due to minor or moderate concerns due to relevancy of evidence, coherence of finding, and/or adequacy of data, as documented in Tables 4.…”

Section: Resultsmentioning

confidence: 99%

“…(45) Certainty of evidence Certainty of evidence has been reviewed and appraised for each sub-theme, reported separately for service user and carer findings in Tables 4. and 5. respectively. There were 28 service user sub-themes, in which we rated overall confidence as high (10), moderate (13), low (3), or very low (2). For the 19 carer sub-themes, we rated overall confidence as high (13), moderate (4), or low (2).…”

Section: Carer Relationshipsmentioning

confidence: 99%

“…Involuntary admissions remain a complex process to navigate for service users and staff, where service users may find it difficult to exercise their rights and express preferences due to being in a ward environment, staff attitudes, or lack of communication (12). Admissions are often associated by experiences of coercion (13), which in turn affects service users’ attitudes towards psychiatric treatment (14). Thus, compulsory admissions present a challenging situation where service users’ well-being, as well as freedom and rights need to be taken into account and respected (15) in addition to clinical considerations.…”

Section: Introductionmentioning

confidence: 99%

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A qualitative meta-synthesis of service users’ and carers’ experiences of assessment and involuntary hospital admissions under mental health legislations: a five-year update

Bartl,

Stuart,

Ahmed

et al. 2024

Preprint

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Background Compulsory admissions occur in psychiatric hospitals around the world. They result in coercive and sometimes traumatic experiences for service users and carers. Legal and service reforms in various countries are intended to reduce rates of detention and improve service user experience. We aimed to inform policy and service delivery by providing an up-to-date synthesis of qualitative evidence on service usersʼ and carersʼ experiences of assessment and detention under mental health legislation, updating previous reviews in which we searched for literature published up to 2018. Methods We searched five bibliographic databases for studies published between January 2018 and March 2023. We identified 24 additional studies reporting qualitative investigations of service usersʼ or carersʼ experiences of assessment or detention under mental health legislation. A team including researchers with relevant personal experience analysed and synthesised data using a thematic synthesis approach. Results Findings suggest that views on compulsory admissions and assessment varied: many reports highlighted its often negative, traumatic impacts on emotional well-being and self-worth, with fewer accounts of it as an opportunity to access help and support, accompanied by feelings of relief. Experiences of racial discrimination, inequality of access, and dissatisfaction with support before and after hospital stay were more prominent than in our previous reviews. Conclusions Increasing service user and carer involvement in treatment decisions, provision of timely information at key stages of the admission process, training of key personnel, addressing the issue of discrimination, and investing in community alternatives of inpatient care may contribute to and lead to better overall treatment experiences.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Carer Relationshipsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A qualitative meta-synthesis of service users’ and carers’ experiences of assessment and involuntary hospital admissions under mental health legislations: a five-year update

Bartl,

Stuart,

Ahmed

et al. 2024

Preprint

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“…This may be reinforced when persons with mental health problems are encouraged to understand aggressive and violent behaviours as part of their own mental health conditions [ 18 ]. However, feeling coerced is rated as traumatic and negative by most service users and relatives [ 19 , 20 ]. Being subjected to coercion can operate as a trigger of past traumatic memories [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

Factors and Processes Facilitating Recovery from Coercion in Mental Health Services—A Meta-Ethnography

Berring,

Georgaca,

Hirsch

et al. 2024

Healthcare

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Background: Being subjected to or witnessing coercive measures in mental health services can have a negative impact on service users, carers and professionals, as they most often are experienced as dehumanising and traumatic. Coercion should be avoided, but when it does happen, it is important to understand how the experience can be processed so that its consequences are managed. Method: A systematic review and meta-ethnography was used to synthesise findings from qualitative studies that examined service users’, staff’s and relatives’ experiences of recovery from being exposed to coercive measures in mental health care settings. We identified, extracted and synthesised, across 23 studies, the processes and factors that were interpreted as significant to process the experience. Results: Recovery from coercion is dependent on a complex set of conditions that support a sense of dignity and respect, a feeling of safety and empowerment. Being in a facilitating environment, receiving appropriate information and having consistent reciprocal communication with staff are the means through which these conditions can be achieved. People employ strategies to achieve recovery, both during and after coercion, to minimise its impact and process the experience. Conclusions: The findings point to the importance of mental health care settings offering recovery-oriented environments and mental health professionals employing recovery-oriented practices, that would empower service users to develop strategies for managing their mental distress as well as their experiences in mental health care in a way that minimises traumatisation and fosters recovery.

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Exploring Patients’ Feeling of Being Coerced During Psychiatric Hospital Admission: A Qualitative Study

et al. 2023

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Various coercive measures can be used to legally compel a person suffering from psychiatric disorder to undergo treatment. However, evidence suggests that patients’ feeling of being coerced is not determined solely by their being submitted to formal coercion. This study aimed to explore voluntary and involuntary patients’ experience of coercion during psychiatric hospitalisation and to identify which factors, from their perspective, most affected it. We chose a qualitative design inspired by a hermeneutic-phenomenological approach. Participants were purposively selected from six psychiatric hospitals in Switzerland. Maximum variation sampling was used to ensure the inclusion of patients with different levels of perceived coercion and different admission statuses. In-depth, semi-structured interviews were co-conducted by a research psychologist and a service-user researcher. The transcribed data underwent thematic analysis. All twelve interviewed patients described the hospitalisation as an experience of loss of control over their life due to either external or internal pressures. During the process, perceptions of these pressures varied and sometimes overlapped, leading some patients to describe their admission as a form of simultaneous protection and violation. The balance between these two contradictory feelings was affected by a variety of contextual and relational factors, as well as by the meaningfulness of the experience and the patient’s subsequent satisfaction with it. Increasing policy-makers’ and clinicians’ awareness about the main factors influencing patients’ experience of loss of control is of paramount importance in order to develop skills and strategies able to address them, reinforcing patients’ empowerment, reducing their feeling of coercion and improving their well-being.

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Feeling coerced during voluntary and involuntary psychiatric hospitalisation: A review and meta-aggregation of qualitative studies

Cited by 13 publications

References 117 publications

A qualitative meta-synthesis of service users’ and carers’ experiences of assessment and involuntary hospital admissions under mental health legislations: a five-year update

A qualitative meta-synthesis of service users’ and carers’ experiences of assessment and involuntary hospital admissions under mental health legislations: a five-year update

Factors and Processes Facilitating Recovery from Coercion in Mental Health Services—A Meta-Ethnography

Exploring Patients’ Feeling of Being Coerced During Psychiatric Hospital Admission: A Qualitative Study

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