"Voluntarily Admitted Against My Will": Patient Perspectives on Effects of, and Alternatives to, Coercion in Psychiatric Care for Self-Injury. (December 2019)

• Record Type: Journal Article
• Authors: Gerle, Ellen; Fischer, Anne; Lundh, Lars-Gunnar
• Is Part Of: Journal of patient experience. Volume 6:Number 4(2019)
• Page Start: 265
• Page End: 270
• Publication Date: 2019-12
• Subjects: perceived coercion -- self-injury -- patient perspective; Patient satisfaction -- Periodicals; Patient satisfaction -- United States -- Periodicals; Patient participation -- Periodicals; Patient participation -- United States -- Periodicals; Patient satisfaction; Patient participation; United States; 362.1068
• DOI: 10.1177/2374373518800811
• Languages: English
• ISSNs: 2374-3735

Abstract

Introduction: Various forms of coercion are used in the psychiatric care of patients with self-injurious behaviors, but there is little research on how these are perceived by the patients. The aim of this study was to investigate how 6 patients, who had received care for self-injurious behavior, perceived coercion and how they think coercion could be avoided. Methods: This study employed a qualitative design with 6 semistructured interviews and interpretative phenomenological analysis. Results: Three main themes were identified: keep voluntary care voluntary, apportioning control and responsibility, and dialogue and participation. Constant supervision was described as the most destructive form of coercion. To enable self-responsibility, a reduction of control and supervision was advocated. Calls were made for a treatment based on the assumption that there is a desire, on behalf of the patients, to get better. Conclusions: The use of coercion in the psychiatric care of patients with self-injurious behavior can be reduced by increasing predictability, by listening to the patient with genuine interest, and by involving the patient in decisions regarding their treatment.