“Voluntarily Admitted Against My Will”: Patient Perspectives on Effects of, and Alternatives to, Coercion in Psychiatric Care for Self-Injury

Abstract

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.

Fear, Neglect, Coercion, and Dehumanization: Is Inpatient Psychiatric Trauma Contributing to a Public Health Crisis?

“…(17) The use of such coercive practices can be highly traumatic, causing feelings of hopelessness and powerlessness. Psychiatrists already have the power to hold patients against their will, leaving the potential for significant harm and ultimately highlighting the need for clear and honest communication in care (20). Not only did patients not know when staff members were being dishonest, but they also feared that staff members would lie at their expense.…”

Mental Health Patients’ Expectations about the Non-Medical Care They Receive in Primary Care: A Cross-Sectional Descriptive Study

“…The actions to carry out from the first level of care are related to the promotion of patient-centred care, recognising the reality of the problems that people with mental disorders face, talking to them without stigmatising them, and listening with empathy [15].…”