Service Users' Experiences of Voluntary Admission to Mental Hospital: A Review of Research Literature

Abstract

Australia and New Zealand are committed to upholding the rights of people who experience mental illness and providing a "recovery" approach to service delivery. These have farreaching implications for acute inpatients, many of whom are admitted voluntarily. In order to inform future research in these two countries, this review aimed to identify literature pertaining to the experiences of people admitted voluntarily to acute adult mental health facilities. Literature was limited to studies in English published between 1993 and 2013. Perceived coercion was the focus of most studies, many of which reported that voluntary service users do not always experience their admission and treatment as strictly voluntary. Two smaller bodies of literature reported that service users were limited in their ability to make informed choices and had poor knowledge of their rights and legal status. Further research on informed consent, knowledge of rights, and access to advocacy is warranted.

Longer term outcomes of voluntarily admitted service users with high levels of perceived coercion

“…The concept of perceived coercion is not restricted to involuntarily admitted service users, with previous studies reporting up to 48% of voluntarily admitted service users describing levels of perceived coercion comparable to that of involuntarily admitted service users (Prebble et al, 2014). Voluntary patients who are treated on locked wards and those with more severe symptoms are more likely to have higher levels of perceived coercion , while those who are more satisfied with their treatment feel less coerced .…”

‘It's unbelievably humiliating’—Patients' expressions of negative effects of coercion in mental health care

“…Also, the patient has privileged access to these end results, while the compulsion used should be readily available to staff. Some forms of compulsion, such as the legal status, are not always known by the patient (Prebble, Thom, & Hudson, 2015).…”

The Need for Making Contact in Times of Crisis

“…Service users focused on making contact, recovery and prevention of crisis in a safe environment with a person who is trusted by the user. This is confirmed in almost all the systematic reviews (Carstensen et al, 2017;Nugteren et al, 2016;Prebble et al, 2015;Wood & Alsawy, 2016). The need for -contact‖ resonates in the wish for collaborative and inclusive care, positive relationships, and a safe and therapeutic hospital environment (Wood & Alsawy, 2016).…”

“…Recently, more attention has been given to the experiences of service users in psychiatric emergency wards. Most studies are conducted by academic researchers on users to gain an insight into their experiences in the acute emergency department of a psychiatric hospital or general emergency department of a hospital (Carstensen et al, 2017;Harris et al, 2016;Nugteren, Hafsteinsdóttir & Kool, 2016;Prebble, Thom & Hudson, 2015;Wood & Alsawy, 2016). For example, Nugteren et al (2016) showed in a systematic review that users experience inappropriate use of the ward rules, nurses' lack of time for interacting with patients, the feeling of humiliation, and lack of involvement of significant others in acute and closed psychiatric wards.…”