Stakeholder experiences with compulsory treatment at home: A focus-group study

Area of Science:

• Mental Health Law
• Psychiatric Care
• Patient Experience

Background:

• Dutch mental health legislation enacted in 2020 permits compulsory treatment at home (CTH).
• CTH differs from compulsory community treatment (CCT) by enabling coercive measures within a patient's residence.
• This legislation offers an alternative to traditional hospital-based compulsory care.

Purpose of the Study:

• To investigate diverse stakeholder perspectives on compulsory treatment at home (CTH).
• To understand the experiences and views related to the implementation of CTH.
• To identify potential benefits, challenges, and preconditions for CTH.

Main Methods:

• The study employed thematic analysis of transcripts from four focus groups.
• Participants included patients, significant others, psychiatrists, and a mixed stakeholder group.
• This qualitative approach facilitated an in-depth exploration of CTH experiences.

Main Results:

• Stakeholders identified potential benefits of CTH, such as avoiding hospitalization.
• Crucial preconditions highlighted include effective communication and advance dialogue between all parties.
• A consensus emerged that CTH is most suitable for patients with established relationships with their treatment teams, enabling collaborative care planning.

Conclusions:

• Compulsory treatment at home (CTH) is viewed as a viable option for specific patient groups with suitable home environments.
• Establishing an advance dialogue and co-creating a crisis plan are essential prerequisites for successful CTH implementation.
• CTH offers a valuable, individualized approach to mental healthcare, complementing existing treatment modalities.