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Cited by 17Healthcare Decision-Making and RestraintsPsychiatric care and mental health servicesHealth, Medicine and Society

Use of compulsory community treatment in mental healthcare: An integrative review of stakeholders’ opinions

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de Waardt, Dieuwertje Anna, van Melle, Anne Laura, Widdershoven, Guy Antoine Marie, Bramer, Wichor Matthijs, van der Heijden, Franciscus Martinus Machiel Adrianus, Rugkåsa, Jorun, Mulder, Cornelis Lambert·2022·Frontiers in Psychiatry
DOI 10.3389/fpsyt.2022.1011961PMC PMC9669570
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Abstract

Background: Multiple studies have examined the effects of compulsory community treatment (CCT), amongst them there were three randomized controlled trials (RCT). Overall, they do not find that CCT affects clinical outcomes or reduces the number or duration of hospital admissions more than voluntary care does. Despite these negative findings, in many countries CCT is still used. One of the reasons may be that stakeholders favor a mental health system including CCT. Aim: This integrative review investigated the opinions of stakeholders (patients, significant others, mental health workers, and policy makers) about the use of CCT. Methods: We performed an integrative review; to include all qualitative and quantitative manuscripts on the views of patients, significant others, clinicians and policy makers regarding the use of CCT, we searched MEDLINE, EMBASE, PsycINFO, CINAHL, Web of Science Core Collection, Cochrane CENTRAL Register of Controlled Trials (via Wiley), and Google Scholar. Results: We found 142 studies investigating the opinion of stakeholders (patients, significant others, and mental health workers) of which 55 were included. Of these 55 studies, 29 included opinions of patients, 14 included significant others, and 31 included mental health care workers. We found no studies that included policy makers. The majority in two of the three stakeholder groups (relatives and mental health workers) seemed to support a system that used CCT. Patients were more hesitant, but they generally preferred CCT over admission. All stakeholder groups expressed ambivalence. Their opinions did not differ clearly between those who did and did not have experience with CCT. Advantages mentioned most regarded accessibility of care and a way to remain in contact with patients, especially during times of crisis or deterioration. The most mentioned disadvantage by all stakeholder groups was that CCT restricted autonomy and was coercive. Other disadvantages mentioned were that CCT was stigmatizing and that it focused too much on medication. Conclusion: Stakeholders had mixed opinions regarding CCT. While a majority seemed to support the use of CCT, they also had concerns, especially regarding the restrictions CCT imposed on patients’ freedom and autonomy, stigmatization, and the focus on medication.

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Authors
de Waardt, D. A., van Melle, A. L., Widdershoven, G. A. M., Bramer, W. M., van der Heijden, F. M. M. A., Rugkåsa, J., & Mulder, C. L.
Affiliations
  • Amsterdam University Medical Centers (NL)
  • Erasmus MC (NL)
  • Akershus University Hospital (NO)
ORCID
Venue
Frontiers in Psychiatry
Publisher
Frontiers Media SA
Published
2022-11-03
Volume
13
Pages
1011961-1011961
ISSN
1664-0640 (ISSN-L)
DOI
10.3389/fpsyt.2022.1011961
PMC
PMC9669570
OpenAlex
W4308416549
Cited by
17
References
5
Citations by year
2026: 4 · 2025: 7 · 2024: 5 · 2023: 1
FWCI
0.54
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Psychiatry (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (acceptedVersion, cc-by)
  • EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
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
compulsory community treatment, mental health law, stakeholder perspectives, patient autonomy, stigma, voluntary care, hospitalization, mental health professionals, relatives of patients, mental health policy

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