Predictors of involuntary patients’ satisfaction with care: prospective study

Abstract

BackgroundInvoluntary admission can be traumatic and is associated with negative attitudes that persist after the episode of illness has abated.AimsWe aimed to prospectively assess satisfaction with care at the points of involuntary admission and symptomatic recovery, and identify their sociodemographic, clinical and service experience predictors.MethodLevels of satisfaction with care, and clinical and sociodemographic variables were obtained from a representative cohort of 263 patients at the point of involuntary admission and from 155 of these patients 3 months after termination of the involuntary admission. Data were analysed with multiple linear regression modelling.ResultsHigher baseline awareness of illness (B = 0.19, P < 0.001) and older age (B = 0.05, P = 0.001) were associated with more satisfaction with care at baseline and follow-up. Transition to greater satisfaction with care was associated with improvements in awareness of illness (B = 0.13, P < 0.001) and in symptoms (B = 0.05, P = 0.02), as well as older age (B = 0.04, P = 0.01). Objective coercive experiences were not associated with variation in satisfaction with care.ConclusionsThere is wide variation in satisfaction with coercive care. Greater satisfaction with care is positively associated with clinical variables such as increased awareness of illness.Declaration of interestNone.

Experiences and Perceptions of Police Officers Concerning Their Interactions With People With Serious Mental Disorders for Compulsory Treatment

“…It is reported by many as a traumatic process, and signifies a loss of patient's autonomy (42). However, “objective” coercive measures do not seem to be related with reduced satisfaction in people who are deprived of their freedom to receive medical treatment (46), but “perceived” coercion seems to be (47). This suggests that measures engaged to promote patient's self-control, such as providing explanations and involving them in the decision-making (42), may decrease the level of perceived coercion in the process of compulsory admission, and may increase the patient's satisfaction with their care and the treatment overall (46).…”

“…However, “objective” coercive measures do not seem to be related with reduced satisfaction in people who are deprived of their freedom to receive medical treatment (46), but “perceived” coercion seems to be (47). This suggests that measures engaged to promote patient's self-control, such as providing explanations and involving them in the decision-making (42), may decrease the level of perceived coercion in the process of compulsory admission, and may increase the patient's satisfaction with their care and the treatment overall (46). Improving patients' satisfaction with care during the compulsory admission process is important not only to provide the highest quality and humane service to patients who require care, but also because low satisfaction levels are linked with poor engagement with services and repeated involuntary admissions (48, 49).…”

Individuals' experiences of involuntary admissions and preserving control: qualitative study

“…A total of 50 individuals, who had been subject to involuntary admissions under the Mental Health Act 2001 and who fulfilled the inclusion criteria (not currently in-patients, no cognitive impairment, able to provide informed written consent for study participation approximately 3 months after termination of their involuntary admission), were recruited from a larger cohort of 156 individuals who agreed to participate and completed follow-up assessments (263 individuals completed the baseline assessments in the follow-up arm of a quantitative prospective study of attitudes towards admission and care in three different in-patient units. 6 , 7 Recruitment to both the quantitative arm of the large study and this grounded theory arm commenced in 2011.…”

Life, liberty and the therapeutic relationship: examining the place of compulsory treatment in modern psychiatry

“…When utilised appropriately and in combination with patient education, research suggests patients may believe that compulsory treatment is justified and report greater satisfaction with care. 21 Conversely, inappropriate use and poor patient education may prolong illness and exacerbate issues with patient engagement and health. The onus therefore lies with psychiatrists to advocate for and correctly utilise resources to maximise patient wellbeing.…”