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Cited by 22Healthcare Decision-Making and RestraintsPsychiatric care and mental health servicesElectroconvulsive Therapy Studies

Exploring Patients’ Feeling of Being Coerced During Psychiatric Hospital Admission: A Qualitative Study

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Silva, Benedetta, Bachelard, Mizué, Bonsack, Charles, Golay, Philippe, Morandi, Stéphane·2023·Psychiatric Quarterly
DOI 10.1007/s11126-023-10039-6PMC PMC10460343
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Abstract

Various coercive measures can be used to legally compel a person suffering from psychiatric disorder to undergo treatment. However, evidence suggests that patients' feeling of being coerced is not determined solely by their being submitted to formal coercion. This study aimed to explore voluntary and involuntary patients' experience of coercion during psychiatric hospitalisation and to identify which factors, from their perspective, most affected it. We chose a qualitative design inspired by a hermeneutic-phenomenological approach. Participants were purposively selected from six psychiatric hospitals in Switzerland. Maximum variation sampling was used to ensure the inclusion of patients with different levels of perceived coercion and different admission statuses. In-depth, semi-structured interviews were co-conducted by a research psychologist and a service-user researcher. The transcribed data underwent thematic analysis. All twelve interviewed patients described the hospitalisation as an experience of loss of control over their life due to either external or internal pressures. During the process, perceptions of these pressures varied and sometimes overlapped, leading some patients to describe their admission as a form of simultaneous protection and violation. The balance between these two contradictory feelings was affected by a variety of contextual and relational factors, as well as by the meaningfulness of the experience and the patient's subsequent satisfaction with it. Increasing policy-makers' and clinicians' awareness about the main factors influencing patients' experience of loss of control is of paramount importance in order to develop skills and strategies able to address them, reinforcing patients' empowerment, reducing their feeling of coercion and improving their well-being.

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  • In both forensic and general psychiatric settings, rules were often perceived as arbitrary, leading to rights deprivation, loss of liberty, and increased uncertainty and tension with healthcare professionals.

    “In both forensic and general psychiatric settings, rules were often perceived as arbitrary, leading to rights deprivation, loss of liberty, and increased uncertainty and tension with healthcare professionals [153].”

    From Factors Associated with Perceived Coercion in Adults Receiving Psychiatric Care: A Scoping Review (2025) · cites this paper as [153]

    The Results (Factors Affecting the Experience; page unavailable) report that patients found some rules unfair, unclear, or subjectively applied, causing loss of autonomy, uncertainty, and tensions with staff. The Results (Loss of Control; page unavailable) also describe admission as a loss of freedom. But the Methods (Recruitment and Participants; page unavailable) describe patients in psychiatric hospitals, not forensic settings, so the claim’s extension to both settings is unsupported. (LLM, conf=0.87)

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  • Psychiatric wards were frequently described as carceral and overly medicalized, contributing to feelings of inferiority.

    “Psychiatric wards were frequently described as carceral [104,153,161] and overly medicalized, contributing to feelings of inferiority [104].”

    From Factors Associated with Perceived Coercion in Adults Receiving Psychiatric Care: A Scoping Review (2025) · cites this paper as [153]

    In Results > Factors Affecting the Experience (page unavailable), patients compare ward rules to prison and a cage; the same section links disrespectful interactions with feelings of worthlessness. The copy does not describe wards as overly medicalized or attribute those feelings to overmedicalization. (LLM, conf=0.84)

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  • Additional concerns included inadequate information about treatment and rights, lack of involvement in decision-making, and limited choices and options.

    “Additional concerns included inadequate information about treatment and rights, lack of involvement in decision-making, and limited choices and options [49,89,149,153,161].”

    From Factors Associated with Perceived Coercion in Adults Receiving Psychiatric Care: A Scoping Review (2025) · cites this paper as [153]

    The Results section (‘Factors Affecting the Experience’; page not provided) reports inadequate information about treatment, barriers to participation in decision-making, and restrictive rules that limited patients’ autonomy and choices. It does not establish that patients received inadequate information about their rights. (LLM, conf=0.86)

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  • Although each professional's approach does influence how care is perceived and the extent to which it is experienced as coercive, the literature also highlights that healthcare workers are trapped within systems that prevent them from intervening in ways that align with their professional values.

    “Although each professional’s approach does influence how care is perceived and the extent to which it is experienced as coercive [47,83,153], the literature also highlights that healthcare workers are trapped within systems that prevent them from intervening in ways that align with their professional values, which are centered on supporting, not controlling, the person [181,182,183].”

    From Factors Associated with Perceived Coercion in Adults Receiving Psychiatric Care: A Scoping Review (2025) · cites this paper as [153]

    Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

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  • Studies focusing on procedural justice and informal coercion emphasized key relational dimensions that either contribute to or alleviate feelings of coercion, including transparent and bidirectional communication and information sharing, trust in professionals' intentions and competence, and avoidance of interventions based on threats, manipulation, or other forms of informal coercion.

    “Studies focusing on procedural justice and informal coercion further emphasized key relational dimensions that either contribute to or alleviate feelings of coercion. These include transparent and bidirectional communication and information sharing, trust in the professionals’ intentions and competence, and the avoidance of interventions and approaches based on threats, manipulation, or other form”

    From Factors Associated with Perceived Coercion in Adults Receiving Psychiatric Care: A Scoping Review (2025) · cites this paper as [153]

    Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

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Cites

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1 of the 67 references couldn’t be matched to a known paper.

Research works printed but not linked: 2

  1. [1]Oxford Dictionaries. Oxford University Press; n.d. “coercion”. https://premium.oxforddictionaries.com/definition/english/coercion. Accessed via Oxford Dictionaries Online on 05 July 2023.
  2. [40]Saldaña J. The coding manual for qualitative researchers. 3rd ed. Sage Publications; 2015.

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Authors
Silva, B., Bachelard, M., Bonsack, C., Golay, P., & Morandi, S.
Affiliations
Centre Hospitalier Universitaire Vaudois (CH)
Corresponding author
Silva, Benedetta
ORCID
Venue
Psychiatric Quarterly
Publisher
Springer Science and Business Media LLC
Published
2023-07-15
Volume
94
Issue
3
Pages
411-434
ISSN
  • 0033-2720 (ISSN-L)
  • 1573-6709
DOI
10.1007/s11126-023-10039-6
PMC
PMC10460343
OpenAlex
W4384406810
Cited by
22
References
67
Citations by year
2026: 8 · 2025: 10 · 2024: 3 · 2023: 1
FWCI
6.39
Type
journal article
Language
en
Open access
Licence
Locations
  • Psychiatric Quarterly (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • SERVAL (Université de Lausanne) (submittedVersion, cc-by)
  • IRIS (submittedVersion, cc-by)
Funders
University of Lausanne
Topics
  • Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
  • Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
  • Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
Keywords
perceived coercion, psychiatric hospital admissions, involuntary admission, voluntary admission, loss of control, patient experience, coercion in mental health care, patient empowerment, patient satisfaction, mental health policy
MeSH terms
Mental Disorders, Coercion, Emotions, Hospitalization, Hospitals, Psychiatric, Humans, Patients

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