Mental Health Professionals' Attitudes Towards Legal Compulsion: Report of a National Survey

Roberts, Caroline; Peay, Jill; Eastman, Nigel

doi:10.1080/14999013.2002.10471162

Cited by 14 publications

(9 citation statements)

References 13 publications

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“…The rate is similar to other e-mail surveys of psychiatrists regarding the process of psychiatric hospitalization, such as 49% in Luchins’ (Luchins, et al ., 2004) and 48.4% in Brooks’ (Brooks, 2006) study, but lower than 60% in Roberts’ (Roberts, et al ., 2002). …”

Section: Resultsmentioning

confidence: 78%

“…The core principle of these criteria is the 'impairment of mental function' and 'need for treatment.' Such standards are similar with the criteria used in Europe (Brooks, 2006;Luchins, Cooper, Hanrahan, & Rasinski, 2004) and the USA (Roberts, Peay, & Eastman, 2002). Finally, the ultimate decision of admission and discharge is left to the capable patient him/herself or the incapable patient's guardian or close relative.…”

Section: Introductionmentioning

confidence: 91%

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Psychiatrists’ attitudes towards the procedure of involuntary admission to mental hospitals in China

Shao

Xie

2011

Int J Soc Psychiatry

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Background In order to protect the rights of the mentally ill, legislation on the standards and procedures of compulsory detention has been made at the local and national level in China. Aims This study aims to examine psychiatrists’ attitude to seeking involuntary admission in China mainland. Method Three hundred and fourteen qualified members of Chinese Psychiatrist Association (CPA) were surveyed using a questionnaire to assess their attitudes about the procedure of involuntary admission to mental hospitals. Data were analyzed using chi-squares and logistic regression. Results Some psychiatrists in CPA had several arbitrary attitudes in the process of admission. Female, age under 35, low education level and low position in institution are associated with stricter attitudes in the procedure of involuntary admission. Areas with mental health legislation showed significant positive relations with stricter attitudes. Conclusions Every effort needs to be made to minimize these arbitrary attitudes to prevent negative outcomes. Protecting the rights of people diagnosed with mental illness still has a long way to go.

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Section: Resultsmentioning

confidence: 78%

Section: Introductionmentioning

confidence: 91%

Psychiatrists’ attitudes towards the procedure of involuntary admission to mental hospitals in China

Shao

Xie

2011

Int J Soc Psychiatry

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“…Consequently, it appeared that the people who decide whether or not to use compulsory admission for psychiatric treatment would be making those decisions within a relatively complex regulatory framework with two key pieces of legislation, one of which potentially conflicted with their professions' values or their personal moral intuitions ( Roberts, Peay, & Eastman, 2002 ). Furthermore, the interface between the two frameworks is complex and poorly understood ( Clare et al, 2013 , House of Lords Select Committee on the Mental Capacity Act ).…”

Section: Introductionmentioning

confidence: 99%

Tensions between policy and practice: A qualitative analysis of decisions regarding compulsory admission to psychiatric hospital

Fistein

Clare

Redley

et al. 2016

International Journal of Law and Psychiatry

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The use of detention for psychiatric treatment is widespread and sometimes necessary. International human rights law requires a legal framework to safeguard the rights to liberty and personal integrity by preventing arbitrary detention. However, research suggests that extra-legal factors may influence decisions to detain. This article presents observational and interview data to describe how decisions to detain are made in practice in one jurisdiction (England and Wales) where a tension between policy and practice has been described. The analysis shows that practitioners mould the law into ‘practical criteria’ that appear to form a set of operational criteria for identifying cases to which the principle of soft paternalism may be applied. Most practitioners also appear willing, albeit often reluctantly, to depart from their usual reliance on the principle of soft paternalism and authorise detention of people with the capacity to refuse treatment, in order to prevent serious harm. We propose a potential resolution for the tension between policy and practice: two separate legal frameworks to authorise detention, one with a suitable test of capacity, used to enact soft paternalism, and the other to provide legal justification for detention for psychiatric treatment of the small number of people who retain decision-making capacity but nonetheless choose to place others at risk by refusing treatment. This separation of detention powers into two systems, according to the principle that justifies the use of detention would be intellectually coherent, consistent with human rights instruments and, being consistent with the apparent moral sentiments of practitioners, less prone to idiosyncratic interpretations in practice.

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“…Evidence from a recent large survey suggests that clinicians generally are divided on the issue of mandatory treatment, but that endorsement of coercion depends a great deal on the clinical situation of the patient-particularly with respect to competence and dangerousness. A survey of 2,022 clinicians in England and Wales (Roberts, Peay, & Eastman, 2002) found that only 21% believed the law should allow compulsory treatment of persons with mental disorders when it is ''evident that they have capacity to decide for themselves.'' Implicitly, this finding suggests that most of the mental health professionals surveyed believed that patients who are competent to make and communicate a decision to refuse treatment should not be compelled by law to accept treatment-even if a clinician disagrees with the patient's decision and believes it to be evidence of poor judgment.…”

mentioning

confidence: 99%

Does fear of coercion keep people away from mental health treatment? Evidence from a survey of persons with schizophrenia and mental health professionals

Swartz

Swanson

Hannon

2003

Behavioral Sci & The Law

138

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Mental health consumer advocates have long argued that involuntary treatment frightens persons with mental disorder and thus deters them from voluntarily seeking help. We surveyed 85 mental health professionals and 104 individuals with schizophrenia spectrum conditions to assess their experience with and perceptions of involuntary treatment and other treatment mandates. Of the clinicians, 78% reported that overall they thought legal pressures made their patients with schizophrenia more likely to stay in treatment. Regarding involuntary outpatient commitment, 81% of clinicians disagreed with the premise that mandated community treatment deters persons with schizophrenia from seeking voluntary treatment in the future. Of the consumer sample, 63% reported a lifetime history of involuntary hospitalization, while 36% reported fear of coerced treatment as a barrier to seeking help for a mental health problem-termed here "mandated treatment-related barriers to care." In bivariate analyses, reluctance to seek outpatient treatment associated with fear of coerced treatment (mandated treatment-related barriers to care) was significantly more likely in subjects with a lifetime history of involuntary hospitalization, criminal court mandates to seek treatment, and representative payeeship. However, experience with involuntary outpatient commitment was not associated with barriers to seeking treatment. Recent reminders or warnings about potential consequences of treatment nonadherence, recent hospitalization, and high levels of perceived coercion generally were also associated with mandated treatment-related barriers to care. In multivariable analyses, only involuntary hospitalization and recent warnings about treatment nonadherence were found to be significantly associated with these barriers. These results suggest that mandated treatment may serve as a barrier to treatment, but that ongoing informal pressures to adhere to treatment may also be important barriers to treatment.

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Mental Health Professionals' Attitudes Towards Legal Compulsion: Report of a National Survey

Cited by 14 publications

References 13 publications

Psychiatrists’ attitudes towards the procedure of involuntary admission to mental hospitals in China

Psychiatrists’ attitudes towards the procedure of involuntary admission to mental hospitals in China

Tensions between policy and practice: A qualitative analysis of decisions regarding compulsory admission to psychiatric hospital

Does fear of coercion keep people away from mental health treatment? Evidence from a survey of persons with schizophrenia and mental health professionals

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