Factual Sources of Psychiatric Patients’ Perceptions of Coercion in the Hospital Admission Process

Charles W. Lidz · Edward P. Mulvey · Steven K. Hoge · Brenda L. Kirsch · John T Monahan · Marlene M. Eisenberg +2 more

106 citations0/0 files storedAmerican Journal of Psychiatry

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Healthcare Decision-Making and Restraints Psychiatric care and mental health services Electroconvulsive Therapy Studies

Abstract

OBJECTIVE: The purpose of this study was to determine what predicts patients' perceptions of coercion surrounding admission to a psychiatric hospital. METHOD: For 171 cases, the authors integrated data from interviews with patients, admitting clinicians, and other individuals involved in the patients' psychiatric admissions with data from the medical records. Using a structured set of procedures, coders determined whether or not nine coercion-related behaviors occurred around the time of admission. Correlation and regression analyses were used to describe the predictors of patients' scores on the MacArthur Perceived Coercion Scale. RESULTS: The use of legal force, being given orders, threats, and "a show of force" were all strongly correlated with perceived coercion. A least squares regression accounted for 43.3% of the variance in perceived coercion. The evidence also suggested that force is typically only used in conjunction with less coercive pressures. CONCLUSIONS: Force and negative symbolic pressures, such as threats and giving orders about admission decisions, induce perceptions of coercion in persons with mental illness. Positive symbolic pressures, such as persuasion, do not induce perceptions of coercion. Such positive pressures should be tried in order to encourage admission before force or negative pressures are used.

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References

1983Human Inference: Strategies and Shortcomings of Social Judgment.1982Book Review Nisbett, R. , & Ross, L.Human inference: Strategies and shortcomings of social judgment.Englewood Cliffs, N.J.: Prentice-Hall, 1980.1993Two scales for measuring patients' perceptions for coercion during mental hospital admission 1995Perceived Coercion in Mental Hospital Admission 1975The Customer Approach to Patienthood 1993Inclusion, motivation, and good faith: The morality of coercion in mental hospital admission 1997Perceptions of coercion in the admission of voluntary and involuntary psychiatric patients 1997Patient perceptions of coercion in mental hospital admission

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2016Clinical Relevance of Informal Coercion in Psychiatric Treatment—A Systematic Review 2012Evaluation of behavioral changes and subjective distress after exposure to coercive inpatient interventions 2016Exploring the views of people with mental health problems' on the concept of coercion: Towards a broader socio-ethical perspective 2011Why do some voluntary patients feel coerced into hospitalisation? A mixed-methods study

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