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Pathways to experienced coercion during psychiatric admission: a network analysis.
Benedetta Silva1,2, Stéphane Morandi3,4, Mizue Bachelard3
1Community Psychiatry Service, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. benedetta.silva@chuv.ch.
BMC Psychiatry
|August 2, 2024
Summary
Reducing formal coercion alone is insufficient to decrease patients' feelings of being coerced in mental health care. Interventions must address factors like patient involvement in decisions and staff interactions to reduce experienced coercion effectively.
Area of Science:
- Psychiatry
- Mental Health Care
- Patient Experience
Background:
- Experienced coercion, or perceived coercion, is a patient's subjective feeling of being coerced.
- Factors beyond formal coercion influence this experience.
- Understanding these interplay factors is crucial for improving mental health care.
Purpose of the Study:
- To explore the interplay of factors contributing to experienced coercion.
- To provide insights into the development of experienced coercion in psychiatric settings.
Main Methods:
- Cross-sectional network analysis of data from 225 psychiatric patients.
- Gaussian Graphical Model (GGM) with EBICglasso regularization.
- Analysis of 13 variables, including centrality indices for network robustness.
Main Results:
- The network analysis revealed a densely connected structure.
- Formal coercion had a weak association with experienced coercion.
- Patient's perceived implication in decision-making, humiliation, and perceived separation from staff were key factors influencing experienced coercion.
Conclusions:
- Reducing formal coercion alone is insufficient to mitigate experienced coercion.
- Interventions should consider stage-specific factors affecting patient experience.
- Tailored strategies addressing decision-making involvement and interpersonal dynamics are recommended.
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