Coercion in Psychiatry: Exploring the Subjective Experience of Coercion Among Patients in Five Portuguese Psychiatric Departments
Abstract
The subjective experience of coercion may have a more significant impact on clinical outcomes than formal coercive measures. 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. Validated instruments, including the McArthur Admission Experience Survey (AES) and the Client Assessment of Treatment Scale, were used to collect information from 208 adults admitted to five public psychiatric inpatient departments in rural and urban regions of Portugal. About a third (32.24%, n = 49) of the sample had a legal involuntary admission status, while more than a third of them perceived their admission to be involuntary (40.13%, n = 61). The subjective experience of coercion was significantly higher among people who perceived their admission to be involuntary compared to people who perceived their admission to be voluntary (Median = 10, IQR = 5.5 vs. Median = 3, IQR = 6; p < 0.001). Satisfaction with their care was significantly inversely correlated with the subjective experience of coercion (p < 0.01). The changes in the subjective experience of coercion at the second assessment were predicted by the perceived admission status rather than the legal admission status, and the initial procedural justice (p < 0.05). The study findings highlight the importance of improving procedural justice in psychiatric admissions, regardless of the legal status of admission.
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No association was found between migration background and perceived coercion.
“Moreover, no association was found between migration background and perceived coercion [139,160].”
From Factors Associated with Perceived Coercion in Adults Receiving Psychiatric Care: A Scoping Review (2025) · cites this paper as [160]
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Factors Associated with Perceived Coercion in Adults Receiving Psychiatric Care: A Scoping Review
Lessard-Deschênes, C., Pariseau-Legault, P., Billé, V., Sergerie-Richard, S., Hudson, E., Silva, B., Drouin, J.-S., Désilets, M., & Goulet, M.-H. (2025) · Healthcare · doi:10.3390/healthcare13151868 · Cited by 10 · see citing works
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Kafka on the Ward: The Kafkaesque Experience of Involuntary Psychiatric AdmissionPreprint
França, G. (2026) · Research Square · doi:10.21203/rs.3.rs-11064332/v1
- Authors
- Aluh, D. O., Diaz-Milanes, D., Azeredo-Lopes, S., Barbosa, S., Santos-Dias, M., Silva, M., Grigaitė, U., Pedrosa, B., Velosa, A., Cardoso, G., & Caldas-de-Almeida, J. M.
- Affiliations
- University of Nigeria (NG)
- Hospital Prof. Dr. Fernando Fonseca (PT)
- Lisbon Institute of Global Mental Health (PT)
- Hospital de Egas Moniz (PT)
- Corresponding author
- Aluh, Deborah Oyine
- ORCID
- Venue
- The Journal of Behavioral Health Services & Research
- Published
- 2024-07-10
- Volume
- 52
- Issue
- 3
- Pages
- 505-524
- ISSN
- 1094-3412 (ISSN-L)
- 1556-3308
- OpenAlex
- W4400491839
- Cited by
- 3
- References
- 44
- Citations by year
- 2026: 2 · 2025: 1
- FWCI
- 1.51
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- The Journal of Behavioral Health Services & Research (publishedVersion)
- PubMed (publishedVersion)
- UBIR (University of Greater Manchester) (submittedVersion)
- Funders
- 'la Caixa' Foundation (LCF/BQ/DI20/11780013)
- Fundação para a Ciência e a Tecnologia (UI/BD/151072/2021, UI/BD/151073/2021)
- 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
- coercion in mental health care, psychiatric hospital admissions, procedural justice, involuntary admission, patient satisfaction, Portugal
- MeSH terms
- Adult, Mental Disorders, Coercion, Commitment of Persons with Psychiatric Disorders, Female, Humans, Male, Middle Aged, Portugal, Psychiatric Department, Hospital, Surveys and Questionnaires, Patient Satisfaction, Young Adult
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