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

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.