Association between perceived coercion and perceived level of information in involuntarily admitted patients: Results from a multicenter observational study in Switzerland
Open accessAbstract
BACKGROUND: Involuntary admissions (IA) to psychiatric hospitals are controversial because they interfere with people's autonomy. In some situations, however, they appear to be unavoidable. Interestingly, not all patients perceive the same degree of coercion during IA. The aim of this study was to assess whether the level of knowledge about one's own IA is associated with perceived coercion. METHODS: This multicenter observational study was conducted on n = 224 involuntarily admitted patients. Interviews were conducted at five study centers from April 2021 to November 2021. The Macarthur Admission Experience Survey was administered to assess perceived coercion. Knowledge of involuntary admission, perceptions of information received, and attitudes towards legal aspects of involuntary admission were also assessed. RESULTS: We found that higher levels of knowledge about IA were negatively associated with perceived coercion at admission. Perceived coercion did not differ between study sites. Only half of the patients felt well informed about their IA, and about a quarter found the information they received difficult to understand. DISCUSSION: Legislation in Switzerland requires that patients with IA be informed about the procedure. Strategies to improve patients' understanding of the information given to them about IA might be helpful to reduce perceived coercion, which is known to be associated with negative attitudes towards psychiatry, a disturbed therapeutic relationship, avoidance of psychiatry, and the risk of further coercion.
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Greater knowledge about one's involuntary admission was associated with lower levels of perceived coercion.
“For example, greater knowledge about one’s involuntary admission was associated with lower levels of perceived coercion [147]”
From Factors Associated with Perceived Coercion in Adults Receiving Psychiatric Care: A Scoping Review (2025) · cites this paper as [147]
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 [147]
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References 46 · Cited by 7
- Authors
- Hotzy, F., Spiess, M., Ruflin, R., Schneeberger, A., Traber, R., Morandi, S., Jaeger, M., & Theodoridou, A.
- Affiliations
- University of Zurich (CH)
- University of California San Diego (US)
- Centre Hospitalier Universitaire Vaudois (CH)
- Corresponding author
- Hotzy, Florian
- Venue
- International Journal of Law and Psychiatry
- Publisher
- Elsevier BV
- Published
- 2023-11
- Volume
- 91
- Pages
- 101934
- ISSN
- 0160-2527 (ISSN-L)
- OpenAlex
- W4386880984
- Cited by
- 7
- References
- 46
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 3 · 2023: 1
- FWCI
- 2.04
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- International Journal of Law and Psychiatry (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Zurich Open Repository and Archive (University of Zurich) (acceptedVersion, cc-by-nc-nd)
- IRIS (submittedVersion, cc-by)
- SERVAL (Université de Lausanne) (submittedVersion, cc-by)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion, cc-by)
- Zurich Open Repository and Archive (University of Zurich)
- Funders
- Bundesamt für Justiz
- Topics
- Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Health Sciences › Health Professions › General Health Professions › Health, Medicine and Society
- Keywords
- involuntary psychiatric admission, perceived coercion, patient information, informed consent, patient autonomy, attitudes toward psychiatry, therapeutic relationship, Switzerland
- MeSH terms
- Mental Disorders, Coercion, Commitment of Persons with Psychiatric Disorders, Commitment of Mentally Ill, Hospitalization, Hospitals, Psychiatric, Humans, Patients, Psychiatry, Switzerland
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