Perceived Treatment Effectiveness as a Predictor of Public Support for Coercive Psychiatric Care

Public support for coercive psychiatric care has been growing. Whereas prior research attributed this trend to stigmatized perceptions of dangerousness or decisional incompetence, few studies explored alternative explanations. The authors therefore aimed to examine whether participants' demographic characteristics, familiarity with mental illness, and perceptions of treatment effectiveness predicted support for coercive care.

Adults (N=250) completed an online survey with vignettes describing individuals with schizophrenia, major depressive disorder, alcohol use disorder, or subclinical distress (control). For each vignette, participants rated the character's decisional competence and dangerousness, treatment effectiveness, and their level of agreement with five forms of coercive care. Hierarchical regression was used to test whether perceived treatment effectiveness or the participants' urbanicity or familiarity with mental illness had explanatory value in the model, in addition to perceived dangerousness or competence. A dominance analysis was used to evaluate the relative importance of each predictor.

For all conditions, the addition of perceived treatment effectiveness improved prediction of support for coercion (p<0.001). The dominance analysis indicated that perceived treatment effectiveness was the most influential predictor in the major depressive disorder, alcohol use disorder, and subclinical distress conditions. For schizophrenia, perceived decisional incompetence was the most influential predictor, followed by perceived treatment effectiveness and dangerousness. The participants' demographic characteristics had minimal influence.

Public support for psychiatric coercion appeared to be informed not only by perceptions of dangerousness or decisional incompetence but also by beliefs about treatment effectiveness. Future research should investigate whether beliefs about potential treatment harms also influence public support for coercive care.