The role of Mental Health Care Act status in dignity-related complaints by psychiatric inpatients: A cross-sectional analytical study

Abstract

Background: Globally interest has grown in promoting the rights of patients, especially psychiatric patients. Two core elements of patients’ rights are the rights to be treated in a dignified manner and to give feedback about services. Psychiatric patients may feel treated in an undignified manner, especially during involuntary hospital admissions.Aim: We explored the relationship between Mental Health Care Act 17 of 2002 (MHCA) status and dignity-related complaints.Setting: The study was conducted at a specialist state psychiatric hospital.Methods: We reviewed 120 registered complaints by psychiatric inpatients, retrieved the clinical files, and analysed 70 complaints. Fisher’s exact tests described the relationship between patients’ MHCA status and the frequency of dignity-related or other categories of complaints. Logistic regression analyses were adjusted for potential covariates.Results: Most complaints were from single, literate male patients, aged 30–39 years, with mood disorders. Most complainants were admitted involuntarily (60%). Dignity-related complaints (n = 41; 58%) outnumbered nondignity-related complaints (n = 29; 41%). The proportion of dignity-related complaints was higher in involuntary (64%) and assisted (60%) patients than in voluntary patients (44%). Dignity-related complaints were not significantly associated with MHCA status (χ2 = 2.03 and p = 0.36). Involuntary patients were more than twice as likely as assisted and voluntary patients to complain about dignity-related matters (Odds ratio [OR]: 2.25; 95% confidence interval [CI] [0.71; 7.13]; p = 0.16).Conclusion: Involuntary patients are more likely to complain about dignity-related matters. Qualitative research is recommended for a deeper understanding of patients’ experiences during admission.

‘Are they really allowed to treat me like that?’ – A qualitative study to explore the nature of formal patient complaints about mental healthcare services in Sweden

“…We recommend that healthcare professionals engage with patients with the sensitivity needed to balance their vulnerability and dignity. This sensitivity will help to empower and support patients with mental ill health, similar to the study by Raphalalani et al (2021). In addition, our study indicates that families can be seen as a resource for a more person-centred care.…”

“…A previous study points to dignity‐related matters being a common reason for the complaints of patients, particularly in involuntary patients with mental ill health (Raphalalani et al . 2021). More work is required to change attitudes and approaches related to dignity, the stigma, and discrimination of patients with mental ill health, and to address unmet mental healthcare needs.…”

“…A need for future qualitative research studies is vital for a deeper understanding of patients’ experiences (Raphalalani et al . 2021). A strength of this study is the sample, which although small, was still large enough to get suitable responses with richness of meanings for a qualitative in‐depth thematic analysis.…”

Experiences of coercion amongst involuntary mental health care users in KwaZulu-Natal, South Africa

“…Involuntary admission is a common practice in SA ( 27 , 29 ), and a recent study from a psychiatric hospital in SA found that involuntary patients were more likely to have dignity-related complaints compared to voluntary patients ( 30 ). It is also important to prevent a negative involuntary admission experience because there is a suggestion that an involuntary admission does not necessarily have to bring about a feeling of coercion ( 31 ).…”

Relapse among MHCUs after a Short-Term Admission in an Acute Psychiatric Unit: Primary Caregivers’ Perspective

“…Mental illness in South Africa was found to be highest in the African region, with the highest prevalence of chronic mental disorders among mental healthcare users (MH-CUs) [1,2]. Many MHCUs are treated as voluntary or involuntary inpatients in the hospital setting before being discharged to a primary health care or home environment [3]. Voluntary and involuntary acute mental healthcare users require short-term treatment therapy during hospitalisation until they are deemed to have recovered enough to be treated as an outpatient [4].…”