Conceptualisation of Informal Coercion in Inpatient Psychiatry: A Scoping Review

Area of Science:

• Mental Health Care
• Psychiatry
• Human Rights

Background:

• Coercion in mental health care is a complex and controversial issue.
• Formal coercion involves overt restrictions or non-consensual treatment.
• Informal coercion, often undocumented, uses subtle communication and interventions.

Purpose of the Study:

• To map the current understanding of informal coercion in inpatient psychiatry.
• To examine definitions and conceptualizations of informal coercion.
• To propose a definition and identify key themes of informal coercion.

Main Methods:

• Scoping review of six databases.
• Data extraction and thematic analysis using Braun and Clarke's approach.
• Synthesis of 29 included articles.

Main Results:

• A definition of informal coercion was proposed.
• Three key themes were identified: professionals' intentions (patient/self-protection), methods (communication, deception, manipulation, abuse of power), and contextual factors (cultural adaptation, rule conformity, professional attitudes/skills).

Conclusions:

• Informal coercion in inpatient psychiatry is complex and requires ethical reflection.
• Clear guidelines and standards are needed to protect patient autonomy and dignity.
• Effective therapeutic interventions must be balanced with patient rights.