When Structural Inequity Is Ubiquitous, Can Force Ever Be Compassionate?
Open accessAbstract
This article contextualizes and challenges race, class, and gender inequity in psychiatric use of force. In particular, this article examines (1) how uses of force-seclusion, restraint, compulsion-have been codified in policy and law, (2) inequity in force utilization, and (3) connections between systemic oppression and individuals' responses-including fear and retraumatization-to feeling threatened by force in clinical settings. This article proposes multilevel strategies to abolish inequity in uses of force in clinical settings and questions whether it is ever possible to use force compassionately where inequity persists.
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“Such disruptions for Black youth limit their access to suicide prevention strategies available in schools (e.g., psychoeducation programs, gatekeeper training) (69).”
From Structural Racism and Suicide Prevention for Ethnoracially Minoritized Youth: A Conceptual Framework and Illustration Across Systems (2022) · cites this paper as [69]
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“In particular, this article examines (1) how uses of force—seclusion, restraint, compulsion—have been codified in policy and law, (2) inequity in force utilization, and (3) connections between systemic oppression and individuals’ responses—including fear and retraumatization—to feeling threatened by force in clinical…”
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- Authors
- Bhattacharyya, S., Breslow, A. S., Carrasco, J., & Cook, B. L.
- Affiliations
- Albert Einstein College of Medicine (US)
- Harvard University (US)
- Venue
- AMA Journal of Ethics
- Publisher
- American Medical Association (AMA)
- Published
- 2021-04-01
- Volume
- 23
- Issue
- 4
- Pages
- E340-348
- ISSN
- 1937-7010 (ISSN-L)
- 2376-6980
- PMC
- PMC13474256
- OpenAlex
- W3150118390
- Cited by
- 5
- References
- 57
- Citations by year
- 2025: 1 · 2022: 4
- FWCI
- 0.68
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- The AMA Journal of Ethic (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (submittedVersion)
- Funders
- National Institute of Mental Health (P50MH126283)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
- Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
- Health Sciences › Medicine › Emergency Medicine › Restraint-Related Deaths
- Keywords
- structural inequality, seclusion, physical restraint, compulsive behavior, race, class, gender, systemic oppression, retraumatization, mental health policy, compassionate care
- MeSH terms
- Mental Disorders, Empathy, Humans, Restraint, Physical
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