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Cited by 13Healthcare Decision-Making and RestraintsPsychiatric care and mental health servicesElectroconvulsive Therapy Studies

Experiences of coercion amongst involuntary mental health care users in KwaZulu-Natal, South Africa

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Shozi, Zinhle, Saloojee, Shamima, Mashaphu, Sibongile·2023·Frontiers in Psychiatry
DOI 10.3389/fpsyt.2023.1113821PMC PMC10027751
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Abstract

Background: Involuntary admission is a common practice globally. Previous international studies reported that patients experienced high levels of coercion, threats and a range of negative emotions. Little is known about the patients’ experience in South Africa. The aim of this study was to describe the patient’s experiences of involuntary admission at two psychiatric hospitals in KwaZulu-Natal. Methods: A cross-sectional descriptive quantitative study of patients admitted involuntarily was conducted. Demographic information was extracted from clinical records and interviews were conducted with consenting participants at discharge. The MacArthur Perceived Coercion Scale, the MacArthur Negative Pressures Scale, and the MacArthur Procedural Justice Scale, of the MacArthur Admission Experience Survey (short form) were utilized to describe participants’ experiences. Results: This study comprised 131 participants. The response rate was 95.6%. Most participants (n = 96; 73%) experienced high levels of coercion and threats (n = 110; 84%) on admission. About half (n = 61; 46.6%) reported that they felt unheard. Participants reported feeling sad (n = 68; 52%), angry (n = 54; 41.2%), and confused (n = 56; 42.7%). There was a significant association between good insight and a feeling of relief (p = 0.001), and between poor insight and feelings of anger (p = 0.041). Conclusion: The findings of this study confirm that most patients who were admitted involuntarily experienced high levels of coercion, threats, and exclusion from the decision-making process. Patient involvement and control of the decision-making process must be facilitated to improve clinical and overall health outcomes. The need for involuntary admission must justify the means.

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Authors
Shozi, Z., Saloojee, S., & Mashaphu, S.
Affiliations
University of KwaZulu-Natal (ZA)
Corresponding author
Shozi, Zinhle
ORCID
Venue
Frontiers in Psychiatry
Publisher
Frontiers Media SA
Published
2023-03-07
Volume
14
Pages
1113821-1113821
ISSN
1664-0640 (ISSN-L)
DOI
10.3389/fpsyt.2023.1113821
PMC
PMC10027751
OpenAlex
W4323363696
Cited by
13
References
48
Citations by year
2026: 3 · 2025: 4 · 2024: 6
FWCI
3.78
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Psychiatry (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
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 › Psychiatry and Mental health › Electroconvulsive Therapy Studies
Keywords
involuntary admission, coercion, psychiatric inpatients, patient experience, threats, procedural justice, patient insight, patient involvement in treatment decisions, negative emotions, psychiatric hospitals, KwaZulu-Natal

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