Key international themes in coercion

Abstract

Coercion remains a dominant theme in mental healthcare and a source of major concern. While the presence of coercion is ubiquitous internationally, it varies significantly in nature and degree in different countries and is influenced by a variety of factors. Recent reports have raised concerns about physical restraint and the increasing use of legislation in high-income countries. At the same time, a recent Human Rights Watch report on pasung (the practice of tying or restricting movement more generally) in Indonesia has served to highlight the plight of many in middle- and lower-income countries who are subject to degrading and dehumanising ‘treatment’.

Criteria, Procedures, and Future Prospects of Involuntary Treatment in Psychiatry Around the World: A Narrative Review

“…Such coercive treatment decreases the arrests of people with mental disorders, improves communication, and shortens the duration of necessary hospitalizations (1). The requirements are the presence of a mental disorder, need for treatment, a patient with poor insight and poor adherence, and a probability of danger toward oneself and others (53).…”

The use of pasung for people with mental illness: a systematic review and narrative synthesis

“…However, human rights abuses persist, are widespread, and go essentially unremarked and unchallenged. The National Human Rights Commission has only recently become engaged in the issue of protection of the rights of persons with mental illness [20] Coercion remains a dominant theme in mental healthcare and a source of major concern in many countries.…”

“…International evidence has confirmed that PWMD are not predominantly those who commit violence but instead are more likely to be victims of violence perpetrated by others [3,4,18]. Examining the use of pasung is essential to address fundamental human rights violations associated with pasung [19,20].…”

Implementation of Guidelines on Prevention of Coercion and Violence (PreVCo) in Psychiatry: Study Protocol of a Randomized Controlled Trial (RCT)

“…Dealing with violence and coercion is regarded as one of the most important aspects of the quality of psychiatric care (16). For many years, the topic has also been classified as highly relevant in Germany, especially against the background of constantly increasing demands for respect of patient autonomy on the one hand and the protection of employees' rights by the Occupational Health and Safety Act on the other hand.…”