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Cited by 14Healthcare Decision-Making and RestraintsPsychiatric care and mental health servicesHealth, Medicine and Society

The locked psychiatric ward: Hotel or detention camp for people with dual diagnosis

Terkelsen, Toril Borch, Larsen, Inger Beate·2013·Journal of Mental Health
DOI 10.3109/09638237.2013.799266
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Abstract

BACKGROUND: The concepts of autonomy and liberty are established goals in mental health care; however, involuntary commitment is used towards people with mental health and substance abuse problems (dual diagnosis). AIMS: To explore how patients and staff act in the context of involuntary commitment, how interactions are described and how they might be interpreted. METHOD: Ethnographic methodology in a locked psychiatric ward in Norway. RESULTS: Two parallel images emerged: (a) The ward as a hotel. Several patients wanted a locked ward for rest and safety, even when admission was classified as involuntary. The staff was concerned about using the ward for real treatment of motivated people, rather than merely as a comfortable hotel for the unmotivated. (b) The ward as a detention camp. Other patients found involuntary commitment and restrictions in the ward as a kind of punishment, offending them as individuals. Contrary, the staff understood people with dual diagnoses more like a generalized group in need of their control and care. CONCLUSION: Patients and staff have different perceptions of involuntary commitment. Based on the patients' points of view, mental health care ought to be characterized by inclusion and recognition, treating patients as equal citizens comparable to guests in a hotel.

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Crossref · 10.3109/09638237.2013.799266

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  • Rigid rules and routines were the most consistently reported as restrictive in the literature.

    “it was the rigid rules and routines that were most consistently reported as restrictive in the literature [51,89,102,104,114,141,142,145,149,152,153,161].”

    From Factors Associated with Perceived Coercion in Adults Receiving Psychiatric Care: A Scoping Review (2025) · cites this paper as [102]

  • Patients described restrictions such as prohibitions on smoking, coffee, or going outside, the inability to use a phone, and needing staff permission for basic needs as profound losses of control.

    “Patients described restrictions such as prohibitions on smoking, coffee, or going outside [102,142], the inability to use a phone [152], and needing staff permission for basic needs [114,141] as profound losses of control.”

    From Factors Associated with Perceived Coercion in Adults Receiving Psychiatric Care: A Scoping Review (2025) · cites this paper as [102]

  • These studies shed light on how structural factors such as rigid ward rules, locked units, lack of privacy, resource scarcity, and dehumanizing practices deeply influence individuals' perceptions of coercion.

    “For instance, these studies shed light on how structural factors such as rigid ward rules, locked units, lack of privacy, resource scarcity, and dehumanizing practices deeply influence individuals’ perceptions of coercion [51,89,102,104,114,141,142,145,149,152,153,161].”

    From Factors Associated with Perceived Coercion in Adults Receiving Psychiatric Care: A Scoping Review (2025) · cites this paper as [102]

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Authors
Terkelsen, T. B., & Larsen, I. B.
Affiliations
  • Department of Health and Nursing Science
  • University of Agder (NO)
Corresponding author
Terkelsen, Toril Borch
ORCID
Terkelsen, Toril Borch
Venue
Journal of Mental Health
Publisher
Informa UK Limited
Published
2013-09-10
Volume
22
Issue
5
Pages
412-419
ISSN
  • 0963-8237 (ISSN-L)
  • 1360-0567
DOI
10.3109/09638237.2013.799266
OpenAlex
W2108366151
Cited by
14
References
29
Citations by year
2026: 1 · 2025: 2 · 2023: 2 · 2022: 3 · 2020: 1 · 2019: 1 · 2018: 2 · 2017: 1 · 2016: 1
FWCI
0.37
Type
journal article
Language
en
Open access
closed
Locations
  • Journal of Mental Health (publishedVersion)
  • PubMed (publishedVersion)
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
dual diagnosis, involuntary admission, patient autonomy, staff-patient interaction, patient perspectives, employee perceptions, substance abuse, mental health services
MeSH terms
Commitment of Persons with Psychiatric Disorders, Health Personnel, Hospitals, Psychiatric, Humans, Norway, Diagnosis, Dual (Psychiatry)

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