Informal coercion in acute inpatient setting—Knowledge and attitudes held by mental health professionals

Clinical Relevance of Informal Coercion in Psychiatric Treatment—A Systematic Review

“…Concerning clinical effects, participants considered informal coercion to be effective in the therapeutic process with respect to promotion of adherence resulting in avoidance of decompensation as well as formal coercion. Nevertheless, one study revealed that interventions with stronger informal coercion were less accepted by mental health professionals (22), and mental health professionals tended to avoid informal coercion and to respect the patients’ decisions if possible although some stated to feel being pressured to use it. Some participants used informal coercion more often than they were aware to use it (21), and one study revealed that the degree of coercion was underestimated in the whole study population.…”

“…Some participants used informal coercion more often than they were aware to use it (21), and one study revealed that the degree of coercion was underestimated in the whole study population. Detailed analysis showed differences in the underestimation of professions with physicians showing the least underestimation of the degree of coercion followed by nurses and other professions (22). Telling patients what to do, being judgmental, and threatening them were rated as the least successful methods (26).…”

“…In order to stay aware and reduce the use of informal coercion, continuous discussions on the issue and supervisions are rated to be helpful. However, it has to be assumed that many situations in which informal coercion is applied in routine practice the acting clinician would not be aware of using informal coercion (22). Corresponding to the included studies on patients’ perspective, professionals’ study participants might not be representative for mental health professionals in general.…”

Reports of cohesion and manifestation of the madness social imaginary by family members and users of mental health at the time of admission

“…The decision to treat can also be by involuntary coercion, when the individual is forced to get treated by threats of negative sanctions, exemplified by the report of P3 3 . 20 Regardless of the type of coercion and by whom it is held, the practice presents as the configuration of the social imaginary and other's demand. The family environment and the social bond do not mean security.…”

“…Coercion occurs when there is a paternalism, a sense of responsibility towards an individual or by a social assessment in order to prevent or reduce undesirable behaviors. 20 It is noteworthy the preventive character of coercive practices, that is, to anticipate a phenomenon not yet manifested. Coercion can, therefore, be characterized as a type of violence for it affects the physical, mental and moral assaulted, resulting in a weakening of the quality of life and health of that individual.…”