How do decision making and fairness mediate the relationship between involuntary hospitalisation and perceived coercion among psychiatric inpatients?
Open accessAbstract
BACKGROUND: Coercion perceived by psychiatric inpatients is not exclusively determined by formal measures such as involuntary admissions, seclusion or restraint, but is also associated with patients' characteristics and professionals' attitude. AIMS: 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 hospitalisation and perceived coercion both at admission and during hospital stay. METHODS: Mediation analysis were performed in order to study the relationship between involuntary hospitalisation and perceived coercion among 230 patients, voluntarily and involuntarily admitted in six psychiatric hospitals. RESULTS: 32.2% of the participants were involuntarily hospitalised. Taken individually, stronger participants' involvement in decision making process, better respect for their decision making preference and higher level of perceived fairness partially mediated the relationship between involuntary hospitalisation and perceived coercion by reducing the level of the latter both at admission and during the hospitalisation. In multiple mediator models, only involvement and respect played an important role at admission. During the hospitalisation, perceived fairness was the most relevant mediator, followed by involvement in decision making. CONCLUSIONS: During psychiatric hospitalisation patients' involvement in decision making, respect of their decision making preference and perceived fairness determined the relationship between involuntary hospitalisation and perceived coercion, but not in the same way at admission and during the stay. Involving patients in decision making and treating them fairly may be more relevant than taking account of their decision making preference in order to reduce perceived coercion.
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Some studies found no significant association between perceived coercion and legal status at admission.
“However, some studies found no significant association between perceived coercion and legal status at admission [54,89,156]”
From Factors Associated with Perceived Coercion in Adults Receiving Psychiatric Care: A Scoping Review (2025) · cites this paper as [156]
The Results (page unavailable) report a statistically significant association between involuntary hospitalisation and perceived coercion at admission (total effect B = 3.85, p < 0.001). The Discussion says the relationship was only partially mediated, not absent. The paper therefore does not support citing this study as one that found no significant association. (LLM, conf=0.88)
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References 52 · Cited by 2
- Authors
- Morandi, S., Silva, B., Pauli, G., Martinez, D., Bachelard, M., Bonsack, C., & Golay, P.
- Affiliations
- Centre Hospitalier Universitaire Vaudois (CH)
- Corresponding author
- Morandi, Stéphane
- ORCID
- Venue
- Journal of Psychiatric Research
- Publisher
- Elsevier BV
- Published
- 2024-05
- Volume
- 173
- Pages
- 98-103
- ISSN
- 0022-3956 (ISSN-L)
- OpenAlex
- W4392888737
- Cited by
- 2
- References
- 52
- Citations by year
- 2025: 2
- FWCI
- 1.00
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Psychiatric Research (publishedVersion, cc-by)
- PubMed (publishedVersion)
- SERVAL (Université de Lausanne) (submittedVersion, cc-by)
- IRIS (submittedVersion, cc-by)
- 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 › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
- Keywords
- involuntary hospitalisation, perceived coercion, psychiatric inpatients, patient involvement in treatment decisions, perceived fairness, mediation, voluntary admission, patient rights
- MeSH terms
- Involuntary Treatment, Mental Disorders, Coercion, Commitment of Mentally Ill, Commitment of Persons with Psychiatric Disorders, Decision Making, Hospitalization, Humans, Inpatients
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