Patients’ experiences of assessment and detention under mental health legislation: systematic review and qualitative meta-synthesis
Open accessAbstract
BACKGROUND: Understanding patient experiences of detention under mental health legislation is crucial to efforts to reform policy and practice. AIMS: To synthesise qualitative evidence on patients' experiences of assessment and detention under mental health legislation. METHOD: Five bibliographic databases were searched, supplemented by reference list screening and citation tracking. Studies were included if they reported on patient experiences of assessment or detention under mental health legislation; reported on patients aged 18 years or older; collected data using qualitative methods; and were reported in peer-reviewed journals. Findings were analysed and synthesised using thematic synthesis. RESULTS: The review included 56 papers. Themes were generally consistent across studies and related to information and involvement in care, the environment and relationships with staff, as well as the impact of detention on feelings of self-worth and emotional state. The emotional impact of detention and views of its appropriateness varied, but a frequent theme was fear and distress during detention, including in relation to the use of force and restraint. Where staff were perceived as striving to form caring and collaborative relationships with patients despite the coercive nature of treatment, and when clear information was delivered, the negative impact of involuntary care seemed to be reduced. CONCLUSIONS: Findings suggest that involuntary in-patient care is often frightening and distressing, but certain factors were identified that can help reduce negative experiences. Coproduction models may be fruitful in developing new ways of working on in-patient wards that provide more voice to patients and staff, and physical and social environments that are more conducive to recovery. DECLARATION OF INTEREST: None.
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In involuntary psychiatric admission and treatment, people are treated like prisoners.
“or prisoners [44]”
From “Backed into a Corner”: Lived experiences of receiving and providing involuntary psychiatric treatment under British Columbia’s Mental Health Act (2026) · cites this paper as [44]
In Results > Thematic synthesis results (page unavailable), the review reports that some patients described wards as akin to prison and felt they were treated as criminals. This supports a prison-like experience, but the claim presents patients’ reported perceptions as a general fact about how people are treated. (LLM, conf=0.82)
Experimental — accuracy not yet measuredPeople who have experienced involuntary psychiatric admission and treatment would have preferred to receive treatment through voluntary means with opportunities for fully informed decision-making.
“Similar to the participants in this study, reports elsewhere have noted study participants views that their primary concern was not with the need for psychiatric retreatment, but that they would have preferred to receive treatment through voluntary means with opportunities for fully informed decision-making [15,44,50].”
From “Backed into a Corner”: Lived experiences of receiving and providing involuntary psychiatric treatment under British Columbia’s Mental Health Act (2026) · cites this paper as [44]
The Results (Thematic synthesis results; page unavailable) report that many patients wanted more involvement in care decisions, and some said they would have complied with medication if offered a fully informed choice. The review also reports that many considered medication important to recovery. It does not establish a general preference for voluntary admission or treatment, or that patients’ primary concern was the manner of treatment rather than its need. (LLM, conf=0.86)
Experimental — accuracy not yet measuredMedication and restraints are the main interventions used during involuntary psychiatric admission and treatment, with little use of other beneficial interventions such as psychotherapy and meaningful recreational, educational, or occupational activities.
“As in this study, previous research describes medication [15,44] and restraints [15] as being the main interventions used during involuntary psychiatric admission and treatment, with little use of other interventions that could be beneficial, such as psychotherapy and meaningful recreational, educational, or occupational activities [44,46].”
From “Backed into a Corner”: Lived experiences of receiving and providing involuntary psychiatric treatment under British Columbia’s Mental Health Act (2026) · cites this paper as [44]
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredInvoluntary psychiatric admission and treatment is stigmatizing.
“and stigmatizing [44,46]”
From “Backed into a Corner”: Lived experiences of receiving and providing involuntary psychiatric treatment under British Columbia’s Mental Health Act (2026) · cites this paper as [44]
In involuntary psychiatric admission and treatment, people are subjected to chaotic and frightening care environments.
“research from other jurisdictions has found that in the context of involuntary psychiatric admission and treatment, people are subjected to chaotic and frightening care environments [44,45]”
From “Backed into a Corner”: Lived experiences of receiving and providing involuntary psychiatric treatment under British Columbia’s Mental Health Act (2026) · cites this paper as [44]
Involuntary psychiatric admission and treatment is frightening.
“frightening [44]”
From “Backed into a Corner”: Lived experiences of receiving and providing involuntary psychiatric treatment under British Columbia’s Mental Health Act (2026) · cites this paper as [44]
Participants in this study noted that making choices is important to their recovery.
“Participants in this study noted that making choices is important to their recovery and being involved in decision-making about their care could increase as their recovery progresses [44].”
From “Backed into a Corner”: Lived experiences of receiving and providing involuntary psychiatric treatment under British Columbia’s Mental Health Act (2026) · cites this paper as [44]
Patients receiving involuntary psychiatric treatment report not being provided information about their rights.
“or their rights [44,47]”
From “Backed into a Corner”: Lived experiences of receiving and providing involuntary psychiatric treatment under British Columbia’s Mental Health Act (2026) · cites this paper as [44]
Participants in this study noted that being involved in decision-making about their care could increase as their recovery progresses.
“Participants in this study noted that making choices is important to their recovery and being involved in decision-making about their care could increase as their recovery progresses [44].”
From “Backed into a Corner”: Lived experiences of receiving and providing involuntary psychiatric treatment under British Columbia’s Mental Health Act (2026) · cites this paper as [44]
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- Authors
- Akther, S. F., Molyneaux, E., Stuart, R., Johnson, S., Simpson, A., & Oram, S.
- Affiliations
- University College London (GB)
- King's College London (GB)
- City, University of London (GB)
- Corresponding author
- Akther, Syeda Ferhana
- Venue
- BJPsych Open
- Publisher
- Royal College of Psychiatrists
- Published
- 2019-04-24
- Volume
- 5
- Issue
- 3
- Pages
- e37-e37
- ISSN
- 2056-4724 (ISSN-L)
- PMC
- PMC6520528
- OpenAlex
- W2940783055
- Cited by
- 193
- References
- 95
- Citations by year
- 2026: 31 · 2025: 29 · 2024: 45 · 2023: 26 · 2022: 18 · 2021: 25 · 2020: 16 · 2019: 3
- FWCI
- 2.45
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BJPsych Open (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (acceptedVersion)
- UCL Discovery (University College London) (acceptedVersion)
- City Research Online (City University London) (acceptedVersion)
- Research Portal (King's College London) (submittedVersion, cc-by-nc)
- Funders
- National Institute for Health and Care Research
- Department of Health and Social Care
- 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 › Mental Health and Patient Involvement
- Keywords
- mental health law, involuntary detention, patient experience, mental health assessment, coercion in mental health care, staff-patient relationship, self-worth, co-production, mental health policy reform
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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