Individuals' experiences of involuntary admissions and preserving control: qualitative study

Abstract

BackgroundA theoretical model of individuals' experiences before, during and after involuntary admission has not yet been established.AimsTo develop an understanding of individuals' experiences over the course of the involuntary admission process.MethodFifty individuals were recruited through purposive and theoretical sampling and interviewed 3 months after their involuntary admission. Analyses were conducted using a Straussian grounded theory approach.ResultsThe ‘theory of preserving control’ (ToPC) emerged from individuals' accounts of how they adapted to the experience of involuntary admission. The ToPC explains how individuals manage to reclaim control over their emotional, personal and social lives and consists of three categories: ‘losing control’, ‘regaining control’ and ‘maintaining control’, and a number of related subcategories.ConclusionsInvoluntary admission triggers a multifaceted process of control preservation. Clinicians need to develop therapeutic approaches that enable individuals to regain and maintain control over the course of their involuntary admission.Declaration of interestNone.

Experiences and Perceptions of Police Officers Concerning Their Interactions With People With Serious Mental Disorders for Compulsory Treatment

“…Its involvement is seen as a valuable and qualified resource, responsible for assisting with the care provision (41). Importantly, the way in which a family starts a compulsory admission process has an effect on how individuals consider the first days of admission and is decisive in the patient's whole experience (42). It has been emphasized already that working in partnership and having discussions between the staff and the family members contributes to the development of best practice (43), to deliver safe and effective interventions (41).…”

“…Hospital admission represents a significant event in the lives of people with serious mental disorders (3). It is reported by many as a traumatic process, and signifies a loss of patient's autonomy (42). However, “objective” coercive measures do not seem to be related with reduced satisfaction in people who are deprived of their freedom to receive medical treatment (46), but “perceived” coercion seems to be (47).…”

“…However, “objective” coercive measures do not seem to be related with reduced satisfaction in people who are deprived of their freedom to receive medical treatment (46), but “perceived” coercion seems to be (47). This suggests that measures engaged to promote patient's self-control, such as providing explanations and involving them in the decision-making (42), may decrease the level of perceived coercion in the process of compulsory admission, and may increase the patient's satisfaction with their care and the treatment overall (46). Improving patients' satisfaction with care during the compulsory admission process is important not only to provide the highest quality and humane service to patients who require care, but also because low satisfaction levels are linked with poor engagement with services and repeated involuntary admissions (48, 49).…”

Refusing Medication Therapy in Involuntary Inpatient Treatment—A Multiperspective Qualitative Study

“…The real concerns of the patients were related to the involuntary hospitalization, the associated restrictions, and how to regain control of their own lives. It is known that the perception of coercion is higher in involuntarily than in most voluntarily hospitalized patients (18), and that it is of particular importance in involuntarily hospitalized inpatients to stay in control and maintain a sense of autonomy (19, 20). As expressed by our respondents, too, perceived loss of autonomy went hand in hand with a more negative relationship between the patients and the clinicians (21).…”

Predicting Inpatient Aggression in Forensic Services Using Remote Monitoring Technology: Qualitative Study of Staff Perspectives

“…Concerns were raised that continuous passive remote monitoring may exacerbate symptoms of paranoia; therefore, establishing trust with users beforehand is likely to be integral to successful implementation. While previous research of passive remote monitoring in the community indicates the acceptability of passive remote monitoring for individuals with psychosis [31-33], it may be a pertinent issue for those involuntarily admitted to inpatient services and experiencing loss of control and restrictive practices [34].…”