Impact of coercive measures on life stories: qualitative study

Br J Psychiatry. 2011 Sep;199(3):239-44. doi: 10.1192/bjp.bp.110.087841. Epub 2011 Jul 21.

Abstract

Background: How people integrate the experience of involuntary hospital admission and treatment into their life narrative has not been explored systematically. Aims To establish a typology of coercion perspectives and styles of integration into life stories.

Method: Transcripts of recorded interviews with 15 persons who had previously been involuntarily admitted to hospital were coded and analysed thematically using a modified grounded theory approach.

Results: With hindsight, people viewed the experience of involuntary hospital admission as a 'necessary emergency brake', an 'unnecessary overreaction' or a 'practice in need of improvement'. With respect to how they integrated the experience into their life narratives, participants viewed it as 'over and not to be recalled', a 'life-changing experience' or a 'motivation for political engagement'.

Conclusions: The participants' diverse and differentiated perspectives on coercive measures and their different styles of integration suggest that people may come to accept coercive measures as necessary when confronted with danger to self or others. However, the implementation of coercion needs to be improved substantially to counteract possible long-term adverse effects.

MeSH terms

  • Adult
  • Aged
  • Coercion*
  • Commitment of Mentally Ill*
  • Dangerous Behavior
  • Female
  • Humans
  • Life Change Events*
  • Male
  • Mental Disorders / therapy
  • Middle Aged
  • Patient Satisfaction*
  • Professional-Patient Relations
  • Qualitative Research
  • Restraint, Physical / psychology*
  • Self Concept
  • Trust / psychology