Association between perceived coercion and perceived level of information in involuntarily admitted patients: Results from a multicenter observational study in Switzerland

Int J Law Psychiatry. 2023 Nov-Dec:91:101934. doi: 10.1016/j.ijlp.2023.101934. Epub 2023 Sep 20.

Abstract

Background: Involuntary admissions (IA) to psychiatric hospitals are controversial because they interfere with people's autonomy. In some situations, however, they appear to be unavoidable. Interestingly, not all patients perceive the same degree of coercion during IA. The aim of this study was to assess whether the level of knowledge about one's own IA is associated with perceived coercion.

Methods: This multicenter observational study was conducted on n = 224 involuntarily admitted patients. Interviews were conducted at five study centers from April 2021 to November 2021. The Macarthur Admission Experience Survey was administered to assess perceived coercion. Knowledge of involuntary admission, perceptions of information received, and attitudes towards legal aspects of involuntary admission were also assessed.

Results: We found that higher levels of knowledge about IA were negatively associated with perceived coercion at admission. Perceived coercion did not differ between study sites. Only half of the patients felt well informed about their IA, and about a quarter found the information they received difficult to understand.

Discussion: Legislation in Switzerland requires that patients with IA be informed about the procedure. Strategies to improve patients' understanding of the information given to them about IA might be helpful to reduce perceived coercion, which is known to be associated with negative attitudes towards psychiatry, a disturbed therapeutic relationship, avoidance of psychiatry, and the risk of further coercion.

Keywords: Coercion; Involuntary admission; Legal regulation; Patients view; Psychiatry.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Coercion
  • Commitment of Mentally Ill
  • Hospitalization
  • Hospitals, Psychiatric
  • Humans
  • Mental Disorders* / psychology
  • Mental Disorders* / therapy
  • Patients
  • Psychiatry*
  • Switzerland