Factors Associated with Perceived Coercion in Adults Receiving Psychiatric Care: A Scoping Review
Abstract
1. Introduction
2. Methods and Analysis
2.1. Eligibility Criteria
2.2. Search Strategy
2.3. Source of Evidence Selection
2.4. Data Extraction
2.5. Data Analysis
3. Results
3.1. Characteristics of Included Literature
Authors and Year of Publication | Goal/Objective | Country | Care Context | Population | Sample Size | Design | Factors Evaluated | Scale Used (If Applicable) |
---|---|---|---|---|---|---|---|---|
Rogers (1993) [32] | The present paper is concerned with three questions: (1) To what extent is the nominal label of “voluntary” an indicator of patients entering and remaining in hospital of their own free will? (2) What was the range of perceptions, beliefs, and circumstances surrounding those who had entered the hospital as voluntary patients but felt themselves to be there under duress? (3) What differences of view, if any, exist about treatment and services between those patients who construed their status to be genuinely voluntary compared to those who did not? | UK | Inpatient | Voluntarily admitted patients | 412 | Mixed methods | Legal status | N/A |
Bennett et al. (1993) [33] | This article presents a qualitative review of the transcripts of a subset of these interviews. It attends specifically to patients’ perceptions of the morality of attempts by others—primarily family members, friends, and mental health professionals—to influence them to be admitted to the hospital, and of the morality of the process by which these influence attempts resulted in admission. | USA | Inpatient | Voluntarily and involuntarily admitted patients | 70 | Qualitative | Inclusion, beneficent motivation, and good faith | N/A |
Lidz et al. (1995) [34] | This article looks at the determinants of patients’ perceptions of coercion. | USA | Inpatient | Voluntarily and involuntarily admitted patients | 157 | Mixed methods | Procedural justice, legal status, and sociodemographic characteristics | MacArthur Admission Experience Interview (AEI) |
Nicholson et al. (1996) [35] | The present study was therefore conducted with three goals in mind: (1) to provide additional data on the psychometric properties of the Perceived Coercion Scale and the MacArthur Admission Experience survey from which the PCS was derived; (2) to investigate the relationship between formal legal status and patients’ perceptions of the coerciveness of hospitalization; and (3) to examine the relationships between patient characteristics, especially the degree of coercion in hospital admission, and several measures of the efficacy of psychiatric hospitalization. | USA | Inpatient | All patients admitted to WSH between 1 March 1993, and 15 June 1993 | 123 | Mixed methods | Legal status and sociodemographic characteristics | MacArthur Admission Experience Survey (AES) |
Hiday et al. (1997) [36] | This paper attempts to develop a better understanding of coercion in psychiatric treatment by studying patient perceptions of coercion and of two closely related constructs—patients’ perceptions of negative pressures in the hospital admission process and patients’ perceptions of fair procedures in the attempts to have them hospitalized. It also examines how these constructs are influenced by sociodemographic and clinical factors. | USA | Outpatient | Involuntarily admitted patients who had been court-ordered to outpatient commitment following hospital discharge | 331 | Quantitative | Clinical characteristics and sociodemographic characteristics | The authors used 15 true-false items from the MacArthur Interpersonal Relations Scale to construct three dependent variables: perceived coercion, perceived negative pressures, and perceived procedural inequity |
Hoge et al. (1997) [37] | In this paper, we report on a study designed to provide preliminary answers to these questions based on patients’ perceptions. (1) How common are “coerced voluntaries” and “uncoerced involuntaries”? (2) When are patients coerced and by whom? Are psychiatrists, other clinicians, or agents of the mental health system pressuring patients? Or are family members and friends responsible for the coercion? (3) How are patients coerced? Are patients being coerced in ways that warrant and are suitable to legal intervention? | USA | Inpatient | Voluntarily and involuntarily admitted patients | 157 | Mixed methods | Legal status | MacArthur Admission Experience Interview (AEI), MacArthur Perceived Coercion Scale (MPCS) |
Cascardi et al. (1997) [38] | This study aims to evaluate patients who were court-ordered to undergo involuntary psychiatric evaluation following the expiration of an initial “emergency” detainment. Of particular interest is whether individuals who were allowed to sign themselves into the hospital as voluntary patients experienced the admission process differently from those for whom involuntary treatment petitions were initiated. The study also seeks to assess whether patients’ perceptions of coercion were more strongly influenced by interactions with community members or with hospital staff. | USA | Inpatient | Inpatients court-ordered to Crisis Stabilization Units (CSUs) for involuntary evaluation | 120 | Quantitative | Legal status, sociodemographic characteristics, and locus of control | MacArthur Admission Experience Interview (AEI) |
Lidz (1998) [39] | This commentary will outline both what is currently known and the directions future research on coercion in psychiatric care must take in the coming decade to remain relevant within our evolving mental health system. | USA | N/A | N/A | N/A | Review and commentary of the literature | Relationship with staff | N/A |
Pescosolido et al. (1998) [40] | The purpose of this study was to systematically consider the different social processes through which people come to enter psychiatric treatment by exploring the stories told by individuals making their first major contact with the mental health system. | USA | Mixed | Inpatients and outpatients making their first major contact with the mental health treatment system | 109 | Mixed methods | Sociodemographic characteristics and social networks | N/A |
Lidz et al. (1998) [41] | The purpose of this study was to determine what predicts patients’ perceptions of coercion surrounding admission to a psychiatric hospital. | USA | Inpatient | Psychiatric inpatient at two university-based hospitals, recently admitted | 171 | Mixed methods | Legal status, sociodemographic characteristics, coercion-related behaviors or events | MacArthur Admission Experience Interview (AEI) |
Hoge et al. (1998) [42] | In the current study, we have included patients, family (including friends and significant others), and clinicians in an attempt to understand two related questions: (1): How do family and clinician perceptions of coercion compare with the Pprceptions of patients? (2): Are the determinants of family and clinician perceptions of coercion the same as the determinants of patient perceptions of coercion? | USA | Inpatient | Data were collected from three groups: newly admitted psychiatric patients, patients’ family members or other significant others who were involved in the admission, and admitting clinicians | 433 | Quantitative | Legal status and sociodemographic characteristics | MacArthur Admission Experience Interview (AEI) |
Gardner et al. (1999) [43] | The authors examine how patients changed their evaluations of psychiatric hospitalization following hospital treatment. | USA | Inpatient | Voluntarily and involuntarily admitted patients | 433 | Quantitative | Legal status and sociodemographic characteristics | MacArthur Perceived Coercion Scale (MPCS) |
Poulsen (1999) [44] | This study aims to investigate differences in perceived coercion among three groups of psychiatric patients: involuntarily committed, voluntarily admitted but later detained, and purely voluntary patients, and to identify predictors of perceived coercion. | Denmark | Inpatient | Psychiatric patients admitted to five closed psychiatric wards at Aarhus University Hospital | 143 | Quantitative | Legal status, clinical characteristics, social functioning, coercive measures, and sociodemographic characteristics | 5-item version of the Admission Experience Scale (AES), Visual Analogue Scale (VAS) |
McKenna et al. (1999) [45] | This study attempted to determine broad views of the current mental health legislation. | New Zealand | Inpatient | Inpatients in two acute psychiatric inpatient services in Auckland, New Zealand | 138 | Quantitative | Previous admission to a psychiatric hospital, previously committed under mental health legislation, and sociodemographic characteristics | MacArthur Admission Experience Survey (AES) |
Lareau (2000) [46] | This dissertation examines differences between legally mandated and non-legally mandated patients on levels of perceived coercion to enter substance abuse treatment, as well as the effect of the therapeutic alliance on altering intake levels of perceived coercion. | USA | Inpatient | Legally mandated and non-legally mandated patients entering drug treatment at two treatment sites in Philadelphia | 69 | Quantitative | Legal status, therapeutic alliance, and procedural justice | MacArthur Admission Experience Survey—Short Form (AES), The Survey of Treatment Entry Pressures (STEP) |
Lidz et al. (2000) [47] | This study aims to describe who places pressures on patients to be admitted to psychiatric hospitals and to understand the sources and nature of coercive behaviors in psychiatric admissions. | USA | Inpatient | Patients admitted to psychiatric hospitals | 433 | Mixed methods | Sources of pressures and types of pressures | MacArthur Perceived Coercion Scale (MPCS) |
McKenna et al. (2001) [48] | The purpose of this study was to consider patients’ perceptions of aspects of procedural justice within the context of voluntary and involuntary admission to psychiatric hospitals in New Zealand and determine which aspects may reduce patients’ perceptions of coercion. | New Zealand | Inpatient | Patients admitted to the two acute-admitting psychiatric units of Waitemata Health, Auckland, New Zealand | 138 | Quantitative | Procedural justice | Perceived Coercion Scale within the MacArthur Admission Experience Survey (AES) |
Olofsson & Jacobsson (2001) [49] | This study highlights how patients narrated their experiences of being subjected to coercion and their thoughts on how coercion could be prevented in Sweden. | Sweden | Inpatient | Involuntarily admitted patients | 18 | Qualitative | Patients and healthcare professionals narrated their experiences of the same coercive event | N/A |
Rosen et al. (2001) [50] | In this study, we surveyed patients enrolled in a money management program at a university-affiliated Community Mental Health Center (CMHC) in order to (1) compare the patients’ relationship to their clinicians to their relationship with their money managers and (2) explore the diverse dimensions of clients’ experience of money management. | USA | Outpatient | Outpatients enrolled in the CMHC money management program | 28 | Quantitative | Legal status, sociodemographic characteristics, and therapeutic alliance | N/A |
Johansson et Lundman (2002) [51] | The study aims to gain a deeper understanding of this experience: patients who are involuntarily admitted to psychiatric care are extremely vulnerable as a consequence of the control from others and of the personal limitations due to a psychiatric disease that can influence their own control of their lives. | Sweden | Inpatient | Involuntarily admitted patients | 5 | Qualitative | Autonomy, perceived coercion, information received, and influence on treatment process | N/A |
Canvin et al. (2002) [52] | The present paper presents the findings of a qualitative investigation into service users’ perceptions and experiences of living with SDOs (Supervised Discharge Orders). | UK | Outpatient | Patient living with SDOs | 20 | Qualitative | Perceptions and experiences of SDOs and impact on freedom | N/A |
Watts & Priebe (2002) [53] | Assertive community treatment (ACT) is a widely propagated team approach to community mental health care that “assertively” engages a subgroup of individuals with severe mental illness who continuously disengage from mental health services. ACT condenses a dilemma that is common in psychiatry. ACT proffers social control whilst simultaneously holding therapeutic aspiration. The clients’ perspective of this dilemma was studied in interviews with 12 clients using the “grounded theory” approach. | UK | Outpatient | Assertive community treatment patients in an impoverished inner-city area of London | 12 | Qualitative | Deinstitutionalization challenges and integration and community opposition | N/A |
Iversen et al. (2002) [54] | In this paper we describe perceived coercion among patients admitted to acute wards in Norway. We applied both the direct and indirect methods to measure perceived coercion. We then compared the two approaches and examined predictors for perceived coercion. | Norway | Inpatient | Voluntarily and involuntarily admitted patients in four acute wards at two Norwegian psychiatric hospitals from October 1998 through November 1999 | 223 | Mixed methods | Sociodemographic characteristics, length of stay, and global assessment of functioning | MacArthur Admission Experience Survey (AES), Coercion Ladder (CL) |
McKenna et al. (2003) [55] | The study aimed to explore the impact of coercion on admissions to forensic psychiatric hospitals and to test the hypothesis that admission to forensic psychiatric hospitals would be associated with significantly greater perceived coercion than that perceived by involuntary admissions to general psychiatric hospitals. A further goal was to determine which aspects of procedural justice might reduce patients’ perceptions of coercion on admission to a forensic psychiatric hospital. | New Zealand | Inpatient | Patients admitted to forensic psychiatric hospitals and involuntary admissions to general psychiatric hospitals in New Zealand | 138 | Quantitative | Negative pressures, procedural justice, and emotional responses to the admission process | Perceived Coercion Scale within the MacArthur Admission Experience Survey (AES) |
Elbogen et al. (2003) [56] | The study aimed to address these questions concerning multiple forms of leverage in treatment and to take preliminary steps toward exploring the combined effects of outpatient commitment (OPC) and representative payees on perceived coercion and treatment adherence. | USA | Outpatient | Patients who had been involuntarily admitted to 1 of 4 hospitals and who were awaiting discharge on outpatient commitment to 1 of 9 counties in north-central North Carolina | 258 | Quantitative | Outpatient commitment | MacArthur Perceived Coercion Scale (MPCS) |
Swanson et al. (2003) [57] | No study to date has directly examined whether legally mandated treatment in the community significantly affects quality of life one way or the other. This paper addresses that question empirically. | USA | Outpatient | Involuntarily hospitalized patients who had been ordered to undergo a period of OPC (involuntary outpatient commitment) upon discharge | 262 | Quantitative | Patients were randomly assigned to be released or continue under outpatient commitment in the community after hospital discharge and were followed for one year. Quality of life, treatment characteristics, and clinical outcomes | MacArthur Admission Experience Survey (AES) |
Sørgaard (2004) [58] | This article presents the results of an intervention study aimed at reducing the level of patient-perceived coercion in two acute wards at a psychiatric hospital in Northern Norway. The interventions consisted of procedures aimed at including the patients in the processes of formulating their treatment plan and in a continuous evaluation of their stay. | Norway | Inpatient | Inpatients in an acute psychiatric ward | 190 | Quantitative | Coercive measures and patronizing attitudes and behaviors | Coercion Ladder (CL) |
Taborda et al. (2004) [59] | The main objective of the present study was the assessment of perceptions of coercion among psychiatric and nonpsychiatric (surgical and medical) patients after admission. | Brazil | Inpatient | Comparison between psychiatric patients and medical/surgical patients | 205 | Quantitative | Legal status and sociodemographic characteristics | MacArthur Admission Experience Survey (AES) |
Bonsack (2005) [60] | The study aimed to assess the subjective perception of psychiatric admission by patients while still in hospital. | Switzerland | Inpatient | Patient admitted to adult psychiatric care | 87 | Quantitative | Legal status and sociodemographic characteristics | N/A |
Van Dorn et al. (2005) [61] | Specifically, the current paper explores the following four interrelated questions: (1) Do persons with serious mental illness think leveraged treatment is fair and effective? (2) What are the characteristics of persons who think that leveraged treatment is fair or unfair, effective or not effective? (3) How are fairness and effectiveness related? (4) How do perceived barriers to care relate to the perceived fairness of leveraged treatment? | USA | Outpatient | Outpatients from publicly funded mental health treatment programs | 1011 | Quantitative | Sociodemographic characteristics, social environment, clinical, and psychological and behavioral profile | N/A |
Rose et al. (2005) [62] | Review of the literature. This study aimed to review patients’ views on issues of information, consent, and perceived coercion about electroconvulsive therapy (ECT). | UK | Inpatient | Patients given ECT | 17 | Review of the literature | Perceived coercion information received about ECT | N/A |
Larsson-Kronberg et al. (2005) [63] | The study aimed to explore the experiences of coercion among individuals undergoing assessment and treatment for substance use disorders under Swedish legislation (LVM) and to understand their perspectives on the entire process from assessment to aftercare. | Sweden | Mixed | Individuals undergoing assessment or with previous experience of assessment and involuntary care under the Swedish Care of Addicts in Certain Cases Act (LVM) | 74 | Quantitative | Contact with healthcare professionals, opportunities to express opinions, emotional reactions to coercive measures, substance use patterns, and treatment satisfaction | Uppsala questionnaire on coercive measures |
Bindman et al. (2005) [64] | This study aimed to investigate predictors of perceived coercion in subjects admitted to psychiatric hospitals in the UK and to test the hypothesis that high perceived coercion at admission predicts poor engagement with community follow-up. | UK | Inpatient | Patients admitted to psychiatric hospitals | 100 | Quantitative | Sociodemographic characteristics, previous contact with services, and objectively coercive aspects of the admission | MacArthur Admission Experience Survey (AES) |
McKenna et al. (2006) [65] | The aim of this study is to determine the level of coercion perceived by those under outpatient commitment in New Zealand. Emphasis is given to consideration of the presence of ambivalence and the role of processes of interaction, including procedural justice, in relation to patients’ perceptions of coercion. | New Zealand | Inpatient | Involuntary outpatient within the first year of their community treatment order presenting for their statutory clinical review | 138 | Quantitative | Sociodemographic characteristics, previous contact with services, and clinical characteristics | MacArthur Admission Experience Survey (AES) |
Swartz et al. (2006) [66] | This study examined lifetime use rates and correlates of outpatient commitment or related civil court–ordered outpatient treatment in five U.S. communities. | USA | Outpatient | Outpatients from five outpatient clinics affiliated with community mental health centers located in Chicago; Durham, North Carolina; San Francisco; Tampa; and Worcester, Massachusetts | 1011 | Quantitative | Sociodemographic characteristics, treatment compliance, clinical characteristics, global assessment of functioning, previous contact with services, and treatment satisfaction | MacArthur Perceived Coercion Scale (MPCS) |
Kjellin et al. (2006) [67] | The objectives of this article are to compare levels of perceived coercion among committed and voluntary patients at admission to psychiatric inpatient care across the five Nordic countries and across centers within countries and to analyze differences in perceived coercion in terms of legal prerequisites and differences in clinical practice. | Switzerland | Inpatient | Voluntarily and involuntarily admitted patients from twelve psychiatric hospitals | 920 | Quantitative | Sociodemographic characteristics, clinical characteristics, global assessment of functioning, and previous contact with services | MacArthur Perceived Coercion Scale (MPCS) |
Appelbaum & Redlich (2006) [68] | This study explores aspects of the population subject to financial leverage, including modeling the predictors of leverage and examining the relationships among financial leverage, treatment compliance, and attitudes toward both treatment and the use of leverage. The goal is to better inform discussions about the legitimate extent of leverage on persons with mental disabilities and the procedures that should regulate these practices. | USA | Outpatient | Outpatients from publicly funded programs were sampled from each of five sites: Chicago, Illinois; Durham, North Carolina; San Francisco, California; Tampa, Florida; and Worcester, Massachusetts | 200 | Quantitative | Treatment compliance, financial leverage, and treatment satisfaction | MacArthur Perceived Coercion Scale (MPCS) |
McKenna et al. (2006) [65] | This thorough literature search on “coercion” and “civil commitment” aimed to outline best practice management strategies for nurses during the clinical application of civil commitment of mentally ill persons. | New Zealand | Mixed | Patients admitted to acute mental health services, acute forensic mental health services, and community mental health services in New Zealand | N/A | Review of the literature | Degree of restriction associated with the service involved, pattern of communication, and procedural justice | N/A |
Castille et al. (2007) [69] | understand why, given the objective difference in the use of coercion, there was no difference in the subjective perception of coercion. | USA | Outpatient | patients discharge from psychiatric hospital on court order or not | 20 | Mixed methods | Court order vs. no court order after hospital discharge relationship with case manager | Not specified |
Katsakou & Priebe (2007) [70] | This study aimed to explore psychiatric patients’ experiences of involuntary admission and treatment by reviewing qualitative studies. | UK | Inpatient | Involuntarily admitted patients in acute general psychiatric wards | 5 | Review of qualitative studies | Autonomy, quality of care, and emotional impact of involuntary treatment | N/A |
Renberg et al. (2007) [71] | This study aimed to investigate determinants for perceived coercion during the admission process among voluntarily and involuntarily admitted psychiatric patients, with special focus on sex-specific patterns. | Sweden | Inpatient | Voluntarily and involuntarily admitted psychiatric patients | 282 | Quantitative | Legal status and sociodemographic characteristics | MacArthur Perceived Coercion Scale (MPCS), Coercion Ladder (CL) |
Sørgaard (2007) [72] | The purpose of this article is to analyze the differences in experienced coercion, patient involvement, and user satisfaction in three groups of patients: voluntary admitted, committed, and a group where the admission was a result of joint decisions between themselves and others. | Norway | Inpatient | Patients in three closed acute wards at the psychiatric department of Nordland Hospital located in the city of Bodø in rural Northern Norway | 189 | Mixed methods | Sociodemographic characteristics, autonomy, clinical characteristics, coercive measures, previous contact with services, and treatment satisfaction | Coercion Ladder (CL) |
Davidson & Campbell (2007) [73] | This paper begins by exploring the literature on coercion and mental health practice and, in doing so, highlights arguments about the relative effectiveness of strategies and ethical dilemmas that are prevalent in this field. The paper concludes with recommendations to develop ways in which practitioners might be better prepared to work within the context of coercive policy and law. | Ireland | Inpatient | The groups consisted of the clients and their respective keyworkers: an Assertive Outreach (AO) group and a Community Mental Health Team (CMHT) group | 157 | Quantitative | Sociodemographic characteristics and clinical characteristics | MacArthur Perceived Coercion Scale (MPCS) |
Zervakis et al. (2007) [74] | This paper examines the association between past involuntary commitment and current perceptions of coercion in a sample of 205 voluntarily hospitalized veterans with severe mental illness. | USA | Inpatient | Voluntarily hospitalized veterans with severe mental illness | 205 | Quantitative | Sociodemographic characteristics, clinical characteristics, global assessment of functioning, legal status, treatment history, coercive measures, alcohol and drug use, insight into illness severity, self-rated health, and social support | MacArthur Admission Experience Survey (AES) |
Link et al. (2008) [75] | This study aimed to address the divergent claims of the coercion to beneficial treatment perspective and the coercion to stigma perspective using a longitudinal study of outpatient commitment among individuals with severe mental illnesses. | USA | Outpatient | Individuals between the ages of 18 and 65, ascertained in treatment facilities in the Bronx and Queens, New York City | 184 | Quantitative | Previous involuntary inpatient hospitalizations, assignment to mandated outpatient treatment (AOT), and perceptions of being coerced into treatment | MacArthur Perceived Coercion Scale (MPCS) |
Johansson et al. (2009) [76] | This study elucidates the meaning care has to patients on a locked acute psychiatric ward. | Sweden | Inpatient | Patients admitted voluntarily or involuntarily to the psychiatric department of a general hospital in Western Sweden | 10 | Qualitative | Sociodemographic characteristics, clinical characteristics, legal status, and previous contact with services | N/A |
Stanhope et al. (2009) [77] | This exploratory study examined the extent to which social interaction between consumers and their case managers is related to the treatment experience from the perspective of consumers. The study addressed the following questions: (1) What factors are associated with perceived coercion by the consumer? (2) To what extent are perceived coercion, the consumer-provider relationship, and consumer and service contact characteristics associated with consumers’ evaluation of a service contact? | USA | Outpatient | Consumers of the Housing First program | 80 | Quantitative | Sociodemographic characteristics, housing status, and service contact characteristics | N/A |
Bennewith et al. (2010) [78] | This study aimed to assess whether adult Black and minority ethnic (BME) patients detained for involuntary psychiatric treatment experienced more coercion than similar White patients. | UK | Inpatient | Patients who had been admitted under Sections 2, 3, or 4 of the Mental Health Act 1983 in the UK or who became involuntary patients within a week of admission | 778 | Quantitative | Sociodemographic characteristics and ethnicity | Coercion Ladder (CL) |
Kim et al. (2010) [79] | This study aimed to investigate variables that influence psychiatric patients’ experience of coercion and the effects of the coercion on the therapeutic relationship. | South Korea | Inpatient | Psychiatric patient | 279 | Quantitative | Sociodemographic characteristics, clinical characteristics, procedural justice, and coercive measures | N/A |
Fu et al. (2010) [80] | Admission experience has been shown to be related to insight and treatment adherence. This study evaluates the clinical correlates of the Chinese Admission Experience Survey (C-AES). | Hong Kong | Inpatient | Inpatients with schizophrenia | 40 | Quantitative | Clinical characteristics and treatment compliance | MacArthur Admission Experience Survey (Chinese version) |
Phelan et al. (2010) [81] | This study aimed to evaluate the effectiveness and outcomes of New York State’s outpatient commitment program, focusing on psychiatric outcomes, quality of life, perceived coercion, and stigma. | USA | Outpatient | Individuals recently mandated to outpatient commitment and individuals recently discharged from psychiatric hospitals | 184 | Quantitative | History of involuntary commitment and number of involuntary hospitalizations | N/A |
Latimer et al. (2010) [82] | This study tested the hypotheses that negative, but not positive, pressures would be associated with higher perceived coercion, and that procedural justice (which we relabeled “client-centredness” for reasons described below) would be associated with lower perceived coercion. Finally, it assessed whether clinical variables were correlated with negative pressures, with client-centeredness, and with perceived coercion. | Canada | Outpatient | Assertive community treatment patients | 38 | Quantitative | Procedural justice, negative pressures, and sociodemographic characteristics | MacArthur Admission Experience Interview (AEI) |
Thøgersen et al. (2010) [83] | This study aimed to explore views on—and perceptions of—coercion of patients in Danish assertive community teams. | Denmark | Outpatient | Assertive community treatment patients | 6 | Qualitative | Influence on treatment process, autonomy, and privacy | N/A |
Patel et al. (2010) [84] | In this study, we investigated patients’ perspectives of coercion for both depot and oral antipsychotic treatment using a quantitative instrument. For the purposes of this study, “coercion” was defined as that perceived by the patient and did not refer to legal detention status. The null hypothesis was that reported levels of coercion would not differ according to current antipsychotic formulation (depot versus oral tablets). | UK | Outpatient | Voluntary outpatients on maintenance medication | 72 | Mixed methods | Sociodemographic characteristics and clinical characteristics | MacArthur Admission Experience Survey (AES) |
Jaeger & Rossler (2010) [85] | This study aimed at investigating the factors influencing psychiatric patients’ subjective measures of perceived coercion, fairness, and effectiveness. We hypothesized that patients with experience of leverage and/or coerced voluntarism were more likely to perceive coercion and would feel they were treated with less fairness and would in consequence evaluate their treatment as less effective. An additional aim was to investigate the influence of insight into illness and socio-demographic and clinical factors on these subjective measures. | Switzerland | Mixed | Inpatients and outpatients at the Department of General and Social Psychiatry, University of Zurich | 187 | Mixed methods | Sociodemographic characteristics, clinical characteristics, global assessment of functioning, and treatment compliance | Modified version of the MacArthur Admission Experience Survey (AES) |
Howard (2010) [86] | This study aimed to examine the effectiveness and cost-effectiveness of women’s crisis houses by first examining the feasibility of a pilot patient-preference randomized controlled trial (PP–RCT) design. | UK | Mixed | Women requiring voluntary admission who could be admitted to a psychiatric inpatient ward or women’s crisis house | 103 | Quantitative | Sociodemographic characteristics, clinical characteristics, global assessment of functioning, quality of life, and satisfaction with care | MacArthur Perceived Coercion Scale (MPCS) |
Daffern et al. (2010) [87] | The aim of the current study is to examine perceptions of coercion and interpersonal style in patients with personality disorder and to examine the relationship between these and subsequent aggression and self-harm during hospitalization. More specifically, do patients with particular interpersonal styles (i.e., hostile and dominant) experience greater coercion, and does this result in them being more likely to act out their frustrations with aggression and self-harm? | Australia | Inpatient | Patients detained under the Mental Health Act (1983) with a legal classification of psychopathic disorder, treated in the Personality Disorder Service at Rampton Hospital | 39 | Mixed methods | Sociodemographic characteristics and clinical characteristics | MacArthur Admission Experience Survey (AES) |
Galon & Wineman (2010) [88] | The primary purpose of this article is to review current information and research related to coercion and the associated concept of procedural justice in mental health treatment and to discuss the implications of this knowledge for nursing practice. A secondary purpose is to spur thought and comment within the psychiatric nursing community on forms of coercive treatment, particularly OPC. | USA | Outpatient | N/A | N/A | Review and discussion of the literature | Procedural justice, outpatient commitment, and coercive measures | N/A |
Newton-Howes et al. (2011) [20] | This study systematically examined the empirical literature on the themes and correlates of coercion as defined by the subjective experience of patients in psychiatric care. | New Zealand | Inpatient | Articles reported on patients in secondary psychiatric care whose treatment was being managed by a consultant psychiatrist | 27 | Systematic review | Sociodemographic characteristics, clinical characteristics, global assessment of functioning, quality of life, and influence on treatment process | N/A |
Katsakou et al. (2011) [89] | The present study aimed (a) to investigate whether specific sociodemographic and clinical characteristics are associated with perceptions of coercion at admission among legally voluntary patients, (b) to examine whether voluntary patients who feel coerced into admission continue to feel coerced during hospital treatment, (c) to identify factors associated with feelings of coercion during treatment, and (d) to explore what experiences—in the view of the patients—lead to feelings of coercion both at admission and during treatment. | UK | Inpatient | Voluntarily admitted patients in nine acute wards in two hospitals in East London | 270 | Mixed methods | Sociodemographic characteristics, clinical characteristics, global assessment of functioning, and satisfaction with care | McArthur Perceived Coercion Scale (MPCS), Coercion Ladder (CL) |
Tschopp et al. (2011) [90] | The purpose of the present study was to evaluate the degree of coercion perceived by mental health consumers in an (Assertive Community Treatment) ACT program, the extent to which coercive strategies are perceived to be implemented, and how perceived coercion might relate to the variables of quality of life, working alliance, and sense of empowerment. | USA | Outpatient | Adults diagnosed with predominantly schizophrenia and schizoaffective disorders in an ACT program in the Midwest of the USA | 65 | Mixed methods | Sociodemographic characteristics and legal status | N/A |
Castille et al. (2011) [91] | In the present chapter we begin with a comparison between the two previously mentioned approaches to measuring coercion. We ask: does a person with a court order perceive him/herself as being more coerced than a person in outpatient treatment without a court order? | USA | Outpatient | Men and women between the ages of 18 and 65 years with a history of serious mental illness from various outpatient clinics in two boroughs of New York City | 184 | Mixed methods | Sociodemographic characteristics, clinical characteristics, quality of life, legal status, and previous contact with services | MacArthur Admission Experience Survey (AES) |
Sheehan & Burns (2011) [15] | The aim of the study was to investigate the association between the therapeutic relationship and perceived coercion in psychiatric admissions. | UK | Inpatient | Patients admitted to psychiatric hospital | 164 | Quantitative | Therapeutic alliance, sociodemographic characteristics, and legal status | MacArthur Admission Experience Survey (AES) |
Galon & Wineman (2011) [92] | This study aimed to compare OPC and ACT as forms of coercive interventions to evaluate the influence of each individually and in combination on treatment compliance and client-centered outcomes, including quality of life, symptom distress, empowerment, violence, and victimization. | USA | Outpatient | Individuals with severe and persistent mental health problems | 154 | Quantitative | Outpatient commitment and assertive community treatment | MacArthur Admission Experience Survey (AES) |
Zuberi et al. (2011) [93] | This article explores perceptions of coercion and hospitalization among patients admitted to a psychiatric unit in Karachi. We looked for associated patient characteristics. | Pakistan | Inpatient | Patients admitted to psychiatric hospital | 87 | Quantitative | Legal status and sociodemographic characteristics | MacArthur Admission Experience Survey (AES) |
Newton-Howes & Stanley (2012) [5] | The aim of this review is therefore to systematically collate those papers that outline the prevalence of perceived coercion to ascertain how common this is and understand the variation in reported rates. An exploration of the factors that may increase or decrease these rates from both a methodological and an epidemiological perspective is also considered. | New Zealand | Mixed | Papers describing adults between 16 and 65 years of age in adult psychiatric care | 18 | Literature review and meta-regression | Legal status, geographical study location, and instruments used to measure coercion | N/A |
Theoridou et al. (2012) [14] | The aim of the present study was to investigate the relationship between perceived coercion and the therapeutic relationship. We hypothesized that perceived coercion would negatively influence the therapeutic relationship as rated by the patient, and vice versa. Thus, we did not posit a unidirectional but a reciprocal effect. We further hypothesized perceived coercion to be influenced by legal status, both at admission and in previous hospitalizations. | Switzerland | Inpatient | Patients admitted to psychiatric hospitals | 116 | Quantitative | Sociodemographic characteristics, clinical characteristics, global assessment of functioning, and legal status | MacArthur Admission Experience Survey (AES) |
Del Vecchio et al. (2012) [94] | This study, conducted within the EUNOMIA project on the evaluation of coercive measures in psychiatry in twelve European countries, intended to assess (1) the clinical and socio-demographic characteristics most frequently associated with higher levels of perceived coercion at admission (2) the relationship between psychiatric symptoms and levels of perceived coercion. | Italy | Inpatient | Patients admitted to psychiatric wards in twelve European countries (Bulgaria, Czech Republic, Germany, Greece, Israel, Italy, Lithuania, Poland, Slovakia, Spain, Sweden, and the United Kingdom) | 2815 | Quantitative | Clinical characteristics, and social functioning | McArthur Perceived Coercion Scale (MPCS) |
Galon et al. (2012) [95] | This study aimed to examine if assignment to OPC status or ACT differed by race and to elucidate the effect of race on the perceptions of procedural justice and coercion in persons subject to OPC. | USA | Outpatient | Patients placed under outpatient commitment (OPC) orders | 140 | Quantitative | Sociodemographic characteristics, and procedural justice | MacArthur Admission Experience Survey (AES) |
Fiorillo et al. (2012) [96] | This study aimed to identify (1) sociodemographic and clinical characteristics associated with perceived coercion at admission and (2) changes in symptoms and global functioning associated with changes in perceived coercion over time. | Italy | Inpatient | Patients who were involuntarily admitted or who felt coerced into hospital treatment despite a legally voluntary admission | 3093 | Mixed methods | Sociodemographic characteristics, clinical characteristics, global assessment of functioning, legal status, and previous contact with services | McArthur Perceived Coercion Scale (MPCS), Cantril Ladder of Perceived Coercion |
Morcos (2012) [97] | This paper aimed to examine the relationship between interpersonal style, attitude to medication and potential adherence, and perceived coercion. | UK | Inpatient | Adult male inpatients from general and forensic psychiatry wards treated with antipsychotic medication | 52 | Quantitative | Interpersonal style and treatment compliance | MacArthur Admission Experience Survey (AES) |
Jaeger et al. (2013) [98] | This paper aimed to examine the long-term influence of involuntary hospitalization on medication adherence, engagement in outpatient treatment and perceived coercion to treatment participation. | Germany | Inpatient | Hospitalized patients with schizophrenia or schizoaffective disorder | 374 | Quantitative | Legal status, sociodemographic characteristics, and clinical characteristics | Compliance Self-Rating Instrument (CSRI-K) |
Anestis et al. (2013) [99] | This study aims to elucidate the characteristics of patients and their admissions that increase the likelihood of perceived coercion during short-term psychiatric hospitalization. It seeks to determine whether interpersonal style—specifically Hostile (H), Dominant (D), and Hostile–Dominant (H–D) styles, which have previously been associated with adverse reactions to hospitalization—along with psychiatric symptoms, gender, and admission status (voluntary or involuntary), predict perceived coercion. Additionally, the study investigates whether the perception of coercion at admission remains stable one year after hospitalization. | Australia | Inpatient | Inpatients admitted to the two acute units at the Alfred Hospital Inpatient Psychiatry Department, in Melbourne, Australia, between 1 March 2009 and 10 August 2009 | 125 | Mixed methods | Legal status, sociodemographic characteristics, and clinical characteristics | MacArthur Admission Experience Survey (AES) |
McNiel et al. (2013) [100] | The study aimed to evaluate the hypothesis that aspects of the treatment relationship, such as the working alliance, psychological reactance, and perceived coercion, could be important in understanding treatment adherence and satisfaction in a group of patients at risk of experiencing leverage. | USA | Outpatient | Outpatients at two community mental health centers | 198 | Quantitative | Working alliance quality, psychological reactance, leverage, sociodemographic characteristics, and clinical characteristics | MacArthur Perceived Coercion Scale (MPCS), adapted for outpatient treatment |
Seo et al. (2013) [101] | This study analyzed whether coercive intervention observed in Korea’s field of mental health could be justified by the basic assumptions of paternalists: the assumptions of incompetence, dangerousness, and impairment. | South Korea | Inpatient | Patients who had been hospitalized following diagnoses of schizophrenia or mood disorders stayed in the hospital for four weeks | 248 | Quantitative | Sociodemographic characteristics, clinical characteristics, and global assessment of functioning | MacArthur Admission Experience Survey (AES) |
Terkelsen & Larsen (2013 [102]) | This study aimed to explore how patients and staff act in the context of involuntary commitment, how interactions are described, and how they might be interpreted. | Norway | Inpatient | People with mental health and substance abuse problems | 38 | Qualitative | Sociodemographic characteristics, clinical characteristics, and characteristics of the therapeutic environment | N/A |
Newton-Howes et al. (2014) [103] | This study aimed to investigate the experience of community treatment orders (CTOs) among Maori and non-Maori patients, comparing their views within mainstream and Maori mental health services. | New Zealand | Outpatient | Patients with experience of CTOs | 79 | Quantitative | Legal status, sociodemographic characteristics, and type of mental health service | MacArthur Perceived Coercion Scale (MPCS) |
Larsen & Terkelsen (2014) [104] | This brief literature review gives a few examples of differences in staff and patient attitudes related to coercion, shows how forced treatment might weaken the alliance between staff and patients, and suggests dialogue and reciprocity as practices to reduce coercion. | Norway | Inpatient | Patients from an inpatient psychiatric unit in Norway | 12 | Qualitative | Legal status and sociodemographic characteristics | N/A |
O’Donoghue et al. (2014) [105] | In this study we aimed to quantify the proportion of voluntarily admitted service users with levels of perceived coercion equivalent to that of involuntarily admitted service users. Secondly, we aimed to identify demographic and clinical characteristics of voluntarily admitted service users who experienced high levels of perceived coercion. | Ireland | Inpatient | Individuals admitted voluntarily and involuntarily to three psychiatric hospitals | 161 | Quantitative | Legal status, clinical characteristics, negative pressures, and procedural justice | MacArthur Perceived Coercion Scale (MPCS) |
Riley et al. (2014) [106] | The objective of this qualitative study was to explore (1) patients’ experiences with OC (outpatient commitment) and (2) how routines in care and health services affect patients’ everyday living. | Norway | Outpatient | Patients under an OC order who had been at least under the order for 3 months and lived in the catchment area | 11 | Qualitative | Accommodation (staffing, supervision, etc.), frequency of monitoring by clinicians, initial contact with mental health services, and clinical characteristics | N/A |
Munetz et al. (2014) [107] | The study aimed to examine levels of perceived coercion, procedural justice, and the impact of mental health court (MHC) and assisted outpatient treatment (AOT) programs among participants in a community treatment system. | USA | Outpatient | Individuals who had graduated from a mental health court program and former AOT participants who were no longer under court supervision | 52 | Quantitative | Interactions with judges and case managers and procedural justice | Modified MacArthur Perceived Coercion Scale (MPCS) |
Prebble et al. (2015) [21] | This review aimed to identify literature pertaining to the experiences of people admitted voluntarily to acute adult mental health facilities. | New Zealand | Inpatient | Publications focused on the experiences of voluntary service users in acute adult psychiatric facilities | 46 | Review of the literature | Legal status, perception of coercion, procedural justice, knowledge of rights, and informed consent | N/A |
Donskoy (2015) [108] | The purpose of this paper is to present a focused viewpoint of coercion in psychiatry from the perspective of a survivor and activist. | UK | Inpatient | Psychiatric inpatients | N/A | Viewpoint of a psychiatric survivor and human rights activist | Lack of capacity, consent, paternalism, complicit psychiatry, and application of human rights standards | N/A |
Canvin (2016) [109] | This chapter presents a synthesis of major research themes and findings on patients’ subjective experiences and perceptions of coercion in community psychiatry. | Unspecified | Outpatient | Patients in community psychiatric settings | N/A | Book chapter: synthesis of the literature | Interventions (medication, appointments); obligations (institutional rules, treatment plans, providers’ expectations); threats; and safety | N/A |
Norvoll & Pedersen (2016) [110] | This study aimed to explore the views of people with mental health problems on the concept of coercion and to argue for a broader socio-ethical perspective on coercion in mental health care. | Norway | Mixed | Adults with various mental health problems and experiences with coercion | 24 | Qualitative | Formal and informal coercion across health and welfare services, power relations, deprivation of freedom, and social and existential impacts of coercion | N/A |
Fugger et al. (2016) [111] | The objective of the present longitudinal investigation was to analyze the burden caused by physical restraint in psychiatric wards. Three specific research questions were addressed: (1) Does the patients’ subjective perception of physical restraint change the longer the time span from the last fixation? (2) Is there a difference between the patients’ and the investigators’ evaluation of physical restraint? (3) Is there a connection between physical restraint and the presence of consecutive posttraumatic stress disorder? | Austria | Inpatient | Patients who were involuntarily admitted and physically restrained at a psychiatric intensive care unit in the general hospital of Vienna (AKH) | 47 | Quantitative | Influence on the treatment process, self-evaluation of physical restraint, symptoms of post-traumatic stress disorder, clinical characteristics, and clinical global impression | MacArthur Admission Experience Survey (AES) |
Francombe Pridham et al. (2016) [22] | This review of literature aimed to examine the relationship between community treatment orders (CTOs) and patients’ perceptions of coercion, with the objective of understanding factors that might influence the experience of being placed under a CTO. | Canada | Outpatient | Publications focused on the experiences of patients who were or had been subject to a community treatment order (CTO) | 23 | Review of the literature | Clinical history and characteristics, procedural justice, the legal and health services context of CTOs, presence of additional forms of leverage, and communication with service providers | N/A |
Raveesh et al. (2016) [112] | This study aimed to assess perceived coercion in persons with mental disorders admitted involuntarily and correlate it with sociodemographic factors and illness variables. | India | Inpatient | Patients admitted involuntarily to a psychiatric hospital | 301 | Quantitative | Sociodemographic characteristics, clinical characteristics, and coercive measures | MacArthur Admission Experience Survey (AES) |
Zlodre et al. (2016) [113] | The current study examined competence and coercion in a cohort of individuals with severe personality disorder who were detained in high-security hospital and prison settings. | UK | Inpatient | Individuals with severe personality disorder who were detained in high-security hospital and prison settings | 174 | Quantitative | Clinical characteristics, competence to consent to treatment, and coercion | MacArthur Admission Experience Survey (AES) |
Abt (2016) [114] | The research question guiding this dissertation is to explore patients’ reactions to coercion. How does it influence their behavior in the relationship they have with healthcare providers? Specifically, the aim is to understand how the patient processes their experience of coercion and how they manage it. | Switzerland | Inpatient | Involuntarily admitted patients | 11 | Qualitative | Patients’ experiences of involuntary hospitalization and therapeutic alliance | N/A |
Opsal et al. (2016) [115] | The present study aimed to investigate the role that perceived coercion played among patients with SUD that entered treatment. We also aimed to clarify whether patients that were admitted involuntarily perceived coercion differently from those that were admitted voluntarily and to identify factors that could predict perceived coercion. | Norway | Inpatient | Voluntarily and involuntarily admitted patients | 192 | Mixed methods | Sociodemographic characteristics, clinical characteristics, and legal status | Perceived Coercion Questionnaire (PCQ) |
Gowda et al. (2016) [116] | The main questions of this study were (1) which coercive measures were taken? (2) What was the perceived coercion at admission and at discharge? (3) Which patient and contextual characteristics were related to perceived coercion at admission and discharge? | India | Inpatient | Patients admitted to psychiatric hospitals | 75 | Quantitative | Sociodemographic characteristics, clinical characteristics, and clinical global impression | MacArthur Perceived Coercion Scale (MPCS), Coercion Ladder (CL) |
Gowda et al. (2017) [117] | We aimed to study coercion experiences among patients with schizophrenia who were admitted involuntarily. Additionally, we also assessed if demographic factors, clinical factors, and the use of coercive measures had any influence on how patients perceived the necessity of their own involuntary admission. | India | Inpatient | Patients with schizophrenia admitted under special circumstances of the Mental Health Act | 76 | Quantitative | Sociodemographic characteristics and clinical characteristics | MacArthur Admission Experience Survey (AES) |
O’Donoghue et al. (2017) [10] | The ‘Service Users’ Perspective of their Admission’ study examined voluntarily and involuntarily admitted service users’ perception of coercion during the admission process and whether this was associated with factors such as the therapeutic alliance, satisfaction with services, functioning, and quality of life. This report aims to collate the findings of the study. | Australia | Inpatient | Involuntarily admitted patient to three psychiatric inpatient units in Dublin and Wicklow | 161 | Quantitative | Sociodemographic characteristics and clinical characteristics | MacArthur Admission Experience Survey (AES) |
Larkin & Hutton (2017) [23] | This systematic review and meta-analysis aimed to determine the direction, magnitude, and reliability of the relationship between capacity in psychosis and a range of clinical, demographic, and treatment-related factors, thus providing a thorough synthesis of current knowledge. | UK | Unspecified | Publications focused on adults diagnosed with a non-affective psychotic disorder | 23 | Systematic review, meta-analytical and narrative synthesis | Sociodemographic characteristics, clinical characteristics, and perceived coercion | N/A |
Anonymous (2017) [118] | This article presents a patient’s experience with psychiatric services. | Lebanon | Mixed | Psychiatric service user | N/A | First-person account | Legal status and relationship with staff | N/A |
Kisely et al. (2017) [119] | This systematic review aims to examine the effectiveness of compulsory community treatment (CCT) for people with severe mental illness (SMI). | Australia | Outpatient | Trials of adults with SMIs who were managed in a community setting | 3 | Systematic review | Comparison I: compulsory community treatment versus entirely voluntary care; comparison II: community treatment orders versus supervised discharge; comparison III: community treatment orders versus standard care | N/A |
Ramachandra et al. (2017) [120] | The present study was aimed at investigating the perceived coercion of psychiatric patients during admission into a psychiatric hospital, keeping the current Mental Health Act 1987 and MHC Bill, 2013, in perspective. | India | Inpatient | Voluntarily and involuntarily admitted patients | 205 | Quantitative | Sociodemographic characteristics, clinical characteristics, legal status, and history of past hospitalization | MacArthur Admission Experience Survey (AES) |
Bradbury et al. (2017) [121] | The aim of the current study was to provide an understanding of the lived experience of involuntary transport (under the MHA) from the perspectives of consumers, carers, mental health nurses, police officers, and ambulance paramedics. | Australia | Inpatient | People with the lived experience of involuntary transport under the MHA: consumers, carers, mental health nurses, police officers, and ambulance paramedics | 16 | Qualitative | Perspectives of consumers, carers, mental health nurses, police officers, and ambulance paramedics | N/A |
Tomlin et al. (2018) [122] | This systematic review examines both empirical and policy literature with the aim of conceptualizing the restrictiveness of forensic care as described by residents, staff, and academic commentators. | UK | Inpatient | Papers were included if they were conducted in secure forensic facilities and involved mentally disordered offenders aged over 18 with any clinical diagnosis | 50 | Systematic review and concept analysis | Phenomenon of restrictiveness as experienced through relationships, institutional characteristics, and systemic factors | N/A |
Horvath et al. (2018) [123] | The present study examines forensic psychiatric inpatients’ perception of coercion regarding the prescribed antipsychotic medication and factors associated with the perception of coercion. | Germany | Inpatient | Patients with schizophrenia, schizotypal, and delusional disorders in two forensic psychiatric institutions in Southern Germany | 56 | Quantitative | Sociodemographic characteristics and clinical characteristics | MacArthur Admission Experience Survey (AES), Coercion Ladder (CL), Coercion Experience Scale (CES) |
Nakhost et al. (2018) [24] | This study aimed to assess the perception of coercion among service users treated under a community treatment order (CTO) compared to a matched comparison group of voluntary psychiatric outpatients and examined the potential predictors of perceived coercion. | Canada | Outpatient | Service users treated under a CTO; voluntary psychiatric outpatients | 138 | Quantitative | Sociodemographic characteristics, clinical characteristics, legal status, procedural justice, and perceived coercion | N/A |
Gowda et al. (2018) [124] | This article aimed to study the prevalence of restraint in an Indian psychiatric inpatient unit and to examine the level of perceived coercion correlating to various forms of restraint. | India | Inpatient | Psychiatric inpatients | 200 | Qualitative | Sociodemographic characteristics, clinical characteristics, legal status, history of past hospitalization, and coercive measures | N/A |
Allison & Flemming (2019) [125] | The aim of this review was to explore mental health patients’ treatment-related experiences of softer coercion and its effect on their interactions with practitioners through a synthesis of qualitative research. There are two main objectives (1) identify patients’ experiences of soft/subtle coercion during admission to, or in, treatment in mental health services and (2) explore the perceived effect of this coercion on patient–practitioner interactions. | UK | Inpatient | Papers describing experiences of patients in mental health services | 11 | Qualitative thematic synthesis | Sense of self, therapeutic alliance and patients’ perception about their transition through treatment | N/A |
Sampogna et al. (2019) [13] | The aim of the study was to (1) identify the sociodemographic and clinical characteristics associated with high levels of perceived coercion at admission in psychiatric wards; (2) assess the relationship between the levels of perceived coercion at admission and the levels of satisfaction with received care after three months of hospitalization in a sample of Italian patients with severe mental disorders. | Italy | Inpatient | Patients admitted to psychiatric hospitals | 294 | Quantitative | Legal status, sociodemographic characteristics, and satisfaction with care | MacArthur Perceived Coercion Scale (MPCS), Cantril Ladder of Perceived Coercion Scale |
Lamothe et al. (2019) [126] | The primary objective was to measure the relationship between coercive stress experienced by patients hospitalized in the psychiatric intensive care unit and their level of insight in order to identify potential psychotherapeutic approaches to improve their experience of care and, consequently, enhance clinical practice. The secondary objective was to highlight a potential link between specific coercive measures (such as seclusion) and coercive stress. | France | Inpatient | Patients who had been hospitalized in the psychiatric intensive care unit of the Caen University Hospital | 40 | Quantitative | Sociodemographic characteristics and clinical characteristics | Coercion Experience Scale (CES) |
Guzmán-Parra et al. (2019) [127] | The objective of this study was to analyze the patients’ perceived coercion, symptoms of post-traumatic stress, and subjective satisfaction with the hospitalization treatment associated with the use of different coercive measures during psychiatric hospital stays, particularly the use of involuntary medication, mechanical restraint, or a combination of these measures. | Spain | Inpatient | Patients who had been subject to coercive measures during their psychiatric hospitalization in the Mental Health Hospitalization Units of the University Regional Hospital of Malaga and the General Hospital of Jerez de la Frontera | 111 | Quantitative | Sociodemographic characteristics, clinical characteristics, coercive measures, satisfaction with treatment, post-traumatic stress, and perceived stress | Coercion Experience Scale (CES), Coercion Ladder (CL) |
Akther et al. (2019) [128] | The aim of this systematic review was to synthesize qualitative evidence of patients’ experiences of being formally assessed for admission and/or the subsequent experience of being detained under mental health legislation. This included any legal processes that take place during the assessment process and during detention, such as mental health tribunals. | UK | Inpatient | Papers describing patients’ experiences of assessment or detention under mental health legislation | 56 | Systematic review and qualitative meta-synthesis | Information and involvement in care, therapeutic environment, relationships with staff, and impact of detention on self-worth and emotional well-being | N/A |
Golay et al. (2019) [129] | The first objective of this study was to disentangle the respective contributions of legal admission status and perceived admission status in predicting perceived coercion. The second objective was to examine the extent to which the perceived usefulness of hospitalization influenced perceived coercion. | Switzerland | Inpatient | Patients hospitalized in the Department of Psychiatry at Lausanne University Hospital | 152 | Mixed methods | Perceived legal status, perceived need for hospitalization, and subjective improvement | MacArthur Admission Experience Survey (AES), Coercion Experience Scale (CES) |
Gerle et al. (2019) [130] | 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. | Sweden | Inpatient | Patients who had engaged in self-injury and had been subjected to coercive measures during treatment | 6 | Qualitative | Threats, coercive measures, control, and involvement in care | N/A |
Mandarelli et al. (2019) [131] | The aim of the present study was to translate into Italian and validate the Admission Experience Survey (I-AES) and to explore its psychometric properties, including factorial structure. A second objective of the study was to investigate differences in perceived coercion in different diagnostic groups of psychiatric patients as well as in voluntarily and involuntarily hospitalized patients. | Italy | Inpatient | Voluntarily and involuntarily admitted patients | 156 | Quantitative | Sociodemographic characteristics and clinical characteristics | MacArthur Admission Experience Survey (Italian version) |
Clément et al. (2020) [132] | The objective of this study is to identify differences in perceptions between nurses and patients regarding their ideal relationship in the context of a first psychotic episode. | Canada | Inpatient | Individuals who experienced involuntary hospitalization in the context of a first psychotic episode; nurses | 10 | Qualitative | Therapeutic alliance | N/A |
Jessell (2020) [133] | This dissertation aimed to understand the relationship between recovery orientation and the role of psychiatric medication in service planning. | USA | Mixed | Users of mental health services | 731 | Mixed methods | Sociodemographic characteristics, clinical characteristics, recovery orientation of the plan, and role of psychiatric medication | N/A |
Scholes et al. (2021) [134] | The aim of this systematic review was to synthesize women service users’ experiences of inpatient mental health services and staff experiences of providing care to women within inpatient mental health services, to appraise the methodological quality of research in this area, and to provide recommendations for clinical practice and future research. | UK | Inpatient | Papers describing the experiences of women service users in inpatient mental health services or staff experiences of providing care to women in these settings | 18 | Systematic review of qualitative evidence | Feeling of safety, perceptions of factors contributing to iatrogenic harm and ineffective inpatient care, and therapeutic environment | N/A |
Schoppmann et al. (2021) [135] | This explorative study investigates baseline expectations and views of patients in forensic wards in German-speaking Switzerland in the context of a recovery-oriented intervention. | Switzerland | Inpatient | Forensic inpatients | 37 | Qualitative | Sociodemographic characteristics, clinical characteristics, length of stay, and reasons for being sentenced | N/A |
Lee & Seo (2021) [136] | This study analyzed the effect of the perceived coercion of persons with mental illness who use community mental health services in Korea on their therapeutic satisfaction and their life satisfaction mediated by the therapeutic relationship. | South Korea | Outpatient | Outpatients with mental disorders aged over 20 years | 185 | Quantitative | Sociodemographic characteristics, clinical characteristics, therapeutic alliance, life satisfaction, and satisfaction with care | MacArthur Admission Experience Survey (AES) |
O’Callaghan et al. (2021) [137] | This study aims to determine the relationships, if any, between perceived coercion on admission and subsequent formal coercive practices during the admission among psychiatry inpatients in Ireland, and any relationships between perceived coercion on admission and other variables such as age, gender, and diagnosis. | Ireland | Inpatient | Voluntary and involuntary psychiatric inpatients aged 18 years or older who were admitted to the acute psychiatric admission units at Tallaght University Hospital and Connolly Hospital in Dublin | 107 | Quantitative | Sociodemographic characteristics, clinical characteristics, legal status, length of stay, level of functioning, and coercive measures | MacArthur Admission Experience Survey (AES) |
Fiore et al. (2021) [138] | This study reviews qualitative studies about long-acting injectable antipsychotic drugs with the aim to gain a better understanding of how LAI therapy is perceived by patients, to analyze the perceived pros and cons of treatment with LAIs in comparison to oral medication, and to investigate factors in favor of each particular method of administration based on the experience and opinions of patients. | Italy | Inpatient | This study includes qualitative research exploring patients’ subjective experiences and attitudes toward long-acting injectables (LAIs) | 220 | Systematic review of qualitative studies | Information received, therapeutic alliance, attitude toward LAIs, coercion, stigma, and recovery | N/A |
Hirsch et al. (2021) [139] | The present study investigates perceived coercion in psychiatric inpatients under prescribed antipsychotic medication without a court order. The objective of this study was to investigate whether and to what extent involuntary and voluntary inpatients feel coerced to take their medication and which factors affect perceived coercion. | Germany | Inpatient | Voluntarily and involuntarily admitted patients | 91 | Quantitative | Sociodemographic characteristics, clinical characteristics, and legal status | MacArthur Admission Experience Survey (AES) |
Mandarelli & Parmigiani (2021) [140] | Tools for health professionals to improve their communication skills; context: in North America principles of informed consent, patient’s autonomy, and case law have established ethical and legal obligations to provide patients with as much information as they desire about their illness and its treatment [7]. | Italy | Unspecified | Psychiatric patients at risk of impaired capacity to consent to treatment | N/A | Book chapter | Legal status and clinical characteristics | N/A |
Tully et al. (2022) [141] | The study aimed to explore women’s experiences of routine restrictive practices in mental health inpatient settings. | UK | Inpatient | Women who were inpatients on psychiatric wards | 22 | Qualitative | Impact of restrictions on relationships, influence on the treatment process, and restrictions providing safety and support | N/A |
Bendall et al. (2022) [142] | The study aimed to explore experiences of restrictive practices from the perspectives of acute care inpatients and staff. | UK | Inpatient | Acute psychiatric inpatients and staff | 17 | Qualitative | Exploring participants’ experiences of situations considered to involve restrictive practices | N/A |
Smyth et al. (2022) [143] | This study aimed to examine and compare retrospective qualitative perceptions of service users in relation to their involuntary admission with their levels of clinical insight, using a mixed-methods approach. | Ireland | Inpatient | Involuntarily admitted inpatients | 42 | Mixed methods | Sociodemographic characteristics, clinical characteristics, and level of insight | N/A |
Plunkett et al. (2022) [144] | This research aimed to provide quantitative data about self-rated dignity among involuntary and voluntary psychiatry inpatients and to explore relationships between perceived dignity and legal status, coercion, level of insight, diagnosis, and therapeutic alliance. | Ireland | Inpatient | Psychiatric inpatients aged 18 years or older | 107 | Quantitative | Legal status, level of insight, negative symptoms, procedural justice, and affective reactions to hospitalization | MacArthur Admission Experience Survey (AES) |
Jina-Pettersen (2022) [145] | This study aimed to further understand experiences of inpatient psychiatric trauma using an anonymous platform to obtain forthright data. | Netherlands | Inpatient | Psychiatric inpatient | 262 | Qualitative | Patients’ lived experiences and subjective perspectives during psychiatric hospitalization | N/A |
Martinez et al. (2022) [146] | The present study aimed to assess the impact of past experience of coercion on the perception of coercion and satisfaction with subsequent voluntary hospitalizations. | Switzerland | Inpatient | Psychiatric patients from six hospitals in the French-speaking region of Switzerland | 140 | Quantitative | Sociodemographic characteristics, satisfaction regarding hospitalization, health and social functioning, and self-reported health | The MacArthur Admission Experience Survey (AES), Coercion Experience Scale (CES) |
Hotzy et al. (2023) [147] | The aim of this study was to analyze whether involuntarily admitted patients in different psychiatric hospitals in Switzerland feel well informed about IA and whether the level of perceived information is associated with perceived coercion. | Switzerland | Inpatient | Involuntarily admitted patients | 224 | Quantitative | Sociodemographic characteristics and experience with involuntary admission | MacArthur Admission Experience Survey (AES) |
Silva et al. (2023) [148] | This review aimed to provide an aggregative synthesis of the qualitative evidence on patients’ experienced coercion during voluntary and involuntary psychiatric hospitalization. | Switzerland | Inpatient | Voluntarily and involuntarily admitted patients | 26 | Review and meta-aggregation of qualitative studies | Patients’ experience of the hospitalization and the associated feeling of coercion, involvement in the decision-making process, and relationships with the staff | N/A |
Carimbocas (2023) [149] | The present mixed-method dissertation study examined the potential association between different levels (high or low) of the MacArthur Admission Experience Scale (MAES) variables (perceived coercion, negative pressures, and procedural justice) and recovery outcomes, which were measured using the Illness Management and Recovery Scale (IMRS). | USA | Inpatient | Adults (18 years and older) who had experienced at least one psychiatric hospitalization in their lifetime | 31 | Mixed methods | Sociodemographic characteristics, clinical characteristics, admission experience, and inpatient experience | MacArthur Admission Experience Scale (AES) |
Wullschleger et al. (2023) [150] | The present study aims to analyze the relationship between patients’ appraisal of the justification of coercive measures and their level of perceived coercion. | Germany | Inpatient | Psychiatric inpatients | 97 | Quantitative | Sociodemographic characteristics, clinical characteristics, and coercive measures | Coercion Experience Scale (CES) |
O’Callaghan et al. (2023) [151] | This paper explores factors linking gender with increased perceived coercion, perceived negative pressures, and procedural injustice during psychiatric admission. | Ireland | Inpatient | Adult psychiatric inpatients admitted to acute psychiatric admission units at two general hospitals in Dublin, Ireland | 107 | Quantitative | Sociodemographic characteristics, legal status, and coercive measures | MacArthur Admission Experience Survey (AES) |
Pelosse (2023) [152] | The aim of this paper was to gain a deeper understanding of the experiences of coercion and support in exercising rights as lived by individuals with mental health issues who are hospitalized or treated involuntarily in psychiatric care. | Canada | Inpatient | Adult individuals with a history of involuntary psychiatric hospitalization or treatment | 11 | Qualitative | Sociodemographic characteristics, coercion, and support in the exercise of rights | N/A |
Silva et al. (2023) [153] | This study aimed to explore voluntary and involuntary patients’ experience of coercion during psychiatric hospitalization and to identify which factors, from their perspective, most affected it. | Switzerland | Inpatient | Inpatients aged between 18 and 65 years who had been hospitalized for more than seven days but less than 15 days | 12 | Qualitative | Relationship with staff, therapeutic environment, and institutional rules | N/A |
Shozi et al. (2023) [154] | The aim of this study was to describe the patient’s experiences of involuntary admission at two psychiatric hospitals in KwaZulu-Natal. | South Africa | Inpatient | Involuntary patients aged 18 years and older | 131 | Quantitative | Sociodemographic characteristics and clinical characteristics | MacArthur Perceived Coercion Scale (MPCS) |
Paun et al. (2024) [155] | The present study aims to evaluate the psychometric properties of a Romanian language version of the AES (R-AES) and to identify predictors for higher perceived coercion. | Romania | Inpatient | Patients admitted to the ‘Professor Doctor Alexandru Obregia’ Psychiatric Hospital in Bucharest | 112 | Quantitative | Sociodemographic characteristics and clinical characteristics | McArthur Admission Experience Survey (Romanian version) |
Morandi et al. (2024) [156] | This study examined how inpatients’ involvement in the decision-making process, the respect of their decision-making preference, and their feeling of having been treated fairly mediate the relationship between involuntary hospitalization and perceived coercion both at admission and during hospital stay. | Switzerland | Inpatient | Voluntary and involuntary hospitalized patients across six psychiatric hospitals in the French-speaking part of Switzerland | 230 | Quantitative | Legal status, involvement in decision-making, respect for patients’ decision-making preferences, and patients’ perceived fairness of treatment pressures | MacArthur Admission Experience Survey (AES) and Coercion Experience Scale (CES) |
Indregard et al. (2024) [157] | In this study, we aimed to compare the occurrence of coercion in open-door policy wards and locked treatment-as-usual wards. | Norway | Inpatient | Psychiatric inpatients at Lovisenberg Diaconal Hospital | 556 | Quantitative | Open-door policy | Experienced coercion scale (ECS) |
Silva et al. (2024) [158] | This study aimed to explore the interplay between these factors and to provide new insights into how they lead to experienced coercion. | Switzerland | Inpatient | Voluntarily and involuntarily admitted patients | 225 | Quantitative | Formal and informal coercion, perceived fairness and effectiveness, implication in decision-making, and satisfaction with hospitalization | MacArthur Admission Experience Survey (AES) |
Fossum et al. (2024) [159] | This study aimed to investigate the association between patient-reported mental health care quality, perceived coercion, and various demographic, clinical, and ward-related factors. | Norway | Inpatient | Psychiatric inpatients | 169 | Quantitative | Quality of care, sociodemographic characteristics, clinical characteristics, and therapeutic environment | Experienced coercion scale (ECS) |
Aluh et al. (2025) [160] | This study aimed to investigate the subjective experience of coercion among patients on admission in Portuguese psychiatric departments by assessing their perceived coercion, procedural justice, and negative pressures during admission. The study also investigated whether this subjective experience of coercion changed with time during admission, and the predictors of this change. | Portugal | Inpatient | Adults admitted to five public psychiatric inpatient departments in rural and urban regions of Portugal | 208 | Quantitative | Procedural justice, time, legal status, satisfaction with care, gender, number of previous admissions, and immigrant status | McArthur Admission Experience Survey (AES), Coercion Ladder (CL) |
Aragones-Calleja & Sánchez-Martínez (2025) [161] | This study aimed to describe and measure users’ experience of coercion and explore their perception of the treatment received in an inpatient medium-stay psychiatric rehabilitation unit (IMSPRU). | Spain | Inpatient | Patients hospitalized in a medium-stay psychiatric rehabilitation unit | 75 | Mixed methods | Relationship with staff and formal and informal coercion | Coercion Experience Scale (CES) |
Nakhost et al. (2025) [162] | This research seeks to address knowledge gaps by studying the prevalence of current experiences of various clinical leverages among general and community mental health outpatients and assessing the relationship between such current clinical leverages and subjective perception of coercion. | Canada | Outpatient | General and community mental health outpatients | 137 | Quantitative | Sociodemographic characteristics, clinical leverages, pressures, perceived coercion, and clinical characteristics | N/A |
Hudson & Beames (2025) [163] | This lived experience narrative recounts the first author’s week-long stay in a psychiatric ED, providing insight into the experiences and challenges of inpatient psychiatric care. | Canada | Inpatient | Psychiatric service user | N/A | Lived experience narrative | Experiences and challenges of inpatient psychiatric care | N/A |
3.2. Themes
3.2.1. Individual
Sociodemographic Characteristics
Affective Style and Self-Perception
Social Environment
3.2.2. Clinical
Diagnosis and Psychiatric Symptoms
Hospitalization History and Trajectory of Care
Type of Treatment and Quality of Care
3.2.3. Relational
Therapeutic Relationship
Informal Coercion
Procedural Justice
3.2.4. Legal
Legal Status at Admission
Other Restrictive Practices
3.2.5. Structural
Institutional Norms and Practices
Institutional Environment and Organization
4. Discussion
4.1. Main Findings
4.2. Methodological Gaps
4.3. Overlooked Populations
4.4. Strengths and Limitations of the Study
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
UK | United Kingdom |
USA | United States of America |
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Database | Search Using Descriptors and Keywords | Filters | Results |
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PUBMED | ((“Coercion”[Mesh] OR “Involuntary Treatment, Psychiatric”[Mesh] OR “Commitment of Mentally Ill”[Mesh] OR “Restraint, Physical”[Mesh:NoExp] OR Coercion[TIAB] OR Coercing[TIAB] OR Coercive[TIAB] OR Coerced[TIAB] OR Involuntary[TIAB] OR Involuntarily[TIAB] OR Commitment[TIAB] OR commitments[TIAB] OR Restraint[TIAB] OR restrained[TIAB] OR Restraining[TIAB] OR Seclusion[TIAB] OR secluded[TIAB] OR Secluding[TIAB] OR Constraint[TIAB] OR constrained[TIAB] OR Constraining[TIAB] OR forced[TIAB] OR force[TIAB] OR compulsory[TIAB] OR intimidation[TIAB] OR intimidate[TIAB] OR intimidated[TIAB]) AND (“Perception”[Mesh:NoExp] OR “Social Perception”[Mesh:NoExp] OR Perception[TIAB] OR perceptions[TIAB] OR Perceived[TIAB] OR Perceive[TIAB] OR Perceiving[TIAB] OR Experience[TIAB] OR experiences[TIAB] OR Experienced[TIAB] OR Experiencing[TIAB] OR Subjective[TIAB])) AND (“Mental Disorders”[Mesh:NoExp] OR “Bipolar and Related Disorders”[Mesh] OR “Schizophrenia Spectrum and Other Psychotic Disorders”[Mesh] OR “Mentally Ill Persons”[Mesh] OR “Hospitals, Psychiatric”[Mesh] OR “Psychiatric Department, Hospital”[Mesh] OR Psychiatric[TIAB] OR Psychiatry[TIAB] OR “Mental health”[TIAB] OR “Mental illness”[TIAB] OR “mental illnesses”[TIAB] OR “Mentally ill”[TIAB] OR “Mental disorder”[TIAB] OR “mental disorders”[TIAB] OR “Mentally disordered”[TIAB] OR Schizophrenia[TIAB] OR Schizophrenic[TIAB] OR Psychosis[TIAB] OR Psychotic[TIAB] OR bipolar[TIAB]) | English, French | 4223 |
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© 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
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Lessard-Deschênes, C.; Pariseau-Legault, P.; Billé, V.; Sergerie-Richard, S.; Hudson, E.; Silva, B.; Drouin, J.-S.; Désilets, M.; Goulet, M.-H. Factors Associated with Perceived Coercion in Adults Receiving Psychiatric Care: A Scoping Review. Healthcare 2025, 13, 1868. https://doi.org/10.3390/healthcare13151868
Lessard-Deschênes C, Pariseau-Legault P, Billé V, Sergerie-Richard S, Hudson E, Silva B, Drouin J-S, Désilets M, Goulet M-H. Factors Associated with Perceived Coercion in Adults Receiving Psychiatric Care: A Scoping Review. Healthcare. 2025; 13(15):1868. https://doi.org/10.3390/healthcare13151868
Chicago/Turabian StyleLessard-Deschênes, Clara, Pierre Pariseau-Legault, Vincent Billé, Sophie Sergerie-Richard, Emilie Hudson, Benedetta Silva, Jean-Simon Drouin, Marie Désilets, and Marie-Hélène Goulet. 2025. "Factors Associated with Perceived Coercion in Adults Receiving Psychiatric Care: A Scoping Review" Healthcare 13, no. 15: 1868. https://doi.org/10.3390/healthcare13151868
APA StyleLessard-Deschênes, C., Pariseau-Legault, P., Billé, V., Sergerie-Richard, S., Hudson, E., Silva, B., Drouin, J.-S., Désilets, M., & Goulet, M.-H. (2025). Factors Associated with Perceived Coercion in Adults Receiving Psychiatric Care: A Scoping Review. Healthcare, 13(15), 1868. https://doi.org/10.3390/healthcare13151868