Patients treated for psychosis and their perceptions of care in compulsory treatment: basis for an action plan

Abstract

The purpose of the study was to describe patients' conceptions and experiences of care in compulsory treatment for acute onset of psychosis. Twelve patients with experience of compulsory treatment were interviewed in 2008-2009, and phenomenographic analysis was used to analyse the data. Two descriptive categories emerged in the results: receiving needed support and perceiving respectful care. Patients perceived that coercive interventions were positive if they were given good care, if they were given the shelter they needed, if they got help with understanding and if the setting was healing. Patients felt respected if they were treated like human beings, if they were allowed to retain as much of their autonomy as possible and if they were invited to participate even though they were under compulsory treatment. The results show that it is important to prevent patients from being traumatized during compulsory treatment and to take advantage of patients' inner resources. Patients' experiences of compulsory treatment can form the basis for preparing an individual action plan for future compulsory treatment. Individual action plans could empower patients during compulsory treatment and improve their experience of care.

The Art of Helpful Relationships with Professionals: A Meta-ethnography of the Perspective of Persons with Severe Mental Illness

“…Moreover, professionals can serve as an important source of information for individuals. By providing information about things such as the care system, mental illness, medication, and rights and obligations, professionals can provide individuals with a wider understanding of the situation and how to handle it [21,28,29,31,33,[35][36][37][38]41]. ''She understands me, but she's trained for that.…”

“…This can be of help to individuals by making the professional capable of claiming or mediating resources or support to them [21,29,33,35,36,41]. By acting like allies [21,31,41] and working together with [38] or exerting influence over [22] other professionals and organizations, professionals can be helpful by making sure individuals get the support and care they need. ''… the authority I needed.…”

“…This supportive role can also mean being a secure and stable person in troubled times, being there to help, being someone to lean on in times of crisis [22,27,28,30,31,33,39,41], and being calm and confident when individuals experience distress [21,27,38]. The supportive role is also demonstrated by the professional taking control and making decisions when individuals are not able to do so for themselves [21,[27][28][29]31].…”

“…The company of professionals is something that is described as positive by participants-'company of professionals' meaning having someone to be with [21,22,33] or doing social things with [23,28,32,38,41].…”

“…Also appreciated is to have comfortable relationships with trusted professionals where issues can be discussed openly, having the opportunity to address challenging questions within the relationship [22,30], as it is important to have good communication about the situation and matters that might arise [26,32,40]. Participants in the studies describe talk about problems and distress as something that is helpful to them [32,35,41], but also express a specific appreciation for talking about things not directly connected to problems, illness or treatment [22,27,28,35,38], and for talking about ordinary and everyday subjects [21,31]. Talking can be helpful through the fact that it can give different perspectives that can help individuals in understanding and handling the issues [21, 24, 31, 35-37, 39, 41], and can help individuals to focus on other things than the distress they experience [21,27].…”