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Patients and next of kins’ attitudes towards compulsory psychiatric care
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centre for Clinical Research, County of Västmanland.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centre for Clinical Research, County of Västmanland.
2008 (English)In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 62, no 6, 444-449 p.Article in journal (Refereed) Published
Abstract [en]

The introduction of a new Civil Commitment Act in Sweden in 1992 involved a shift of emphasis from medical to judicial authority. Little is known about general patient attitudes to compulsory care. The aim of the study was to study possible differences in attitudes, before and after the mental health law reform, among involuntarily and voluntarily admitted patients and their next-of-kins towards involuntary psychiatric admission. Samples of 84 committed and 84 voluntarily admitted patients in 1991 and 118 committed and 117 voluntarily admitted patients in 1997-99 were interviewed within 5 days from admission and at discharge, or after 3 weeks of care. Samples of 64 next-of-kins to the committed patients and 69 next-of-kins to the voluntarily admitted patients in 1991, and 73 and 89 next-of-kins, respectively, in 1997-99 were interviewed approximately 1 month after the admission. Few changes in attitudes were found between the two study occasions. A majority of all patients stated that it should be possible to compulsorily admit patients, and a great majority of the patients and the next-of kins stated that decisions regarding compulsory admission should be taken by doctors. Most patients and next-of-kins regarded decisions about involuntary psychiatric care mainly as a medical matter. Strong support for coercion in order to protect the patient and others was found among next-of-kins. The law reform was not reflected in attitudinal differences.

Place, publisher, year, edition, pages
2008. Vol. 62, no 6, 444-449 p.
Keyword [en]
Attitudes, Coercion, Compulsory psychiatric care
National Category
Psychiatry
Identifiers
URN: urn:nbn:se:uu:diva-96984DOI: 10.1080/08039480801984248ISI: 000261088600005PubMedID: 18985515OAI: oai:DiVA.org:uu-96984DiVA: diva2:171740
Available from: 2008-03-28 Created: 2008-03-28 Last updated: 2017-12-14Bibliographically approved
In thesis
1. Compulsory Psychiatric Care: Perspectives from the Swedish Coercion Study: Patient Experiences, Documented Measures, Next of Kins’ Attitudes and Outcome
Open this publication in new window or tab >>Compulsory Psychiatric Care: Perspectives from the Swedish Coercion Study: Patient Experiences, Documented Measures, Next of Kins’ Attitudes and Outcome
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The use of coercion in psychiatry involves clinical, legal, scientific, ethical and emotional considerations. This thesis represents an attempt to further increase our understanding of some empirical aspects of this phenomenon.

Interviews with 202 involuntarily admitted psychiatric patients and 201 voluntarily admitted patients and 295 of their next of kins were performed and analysed together with data from records and assessments made by professionals. Data was collected during two different periods of time with a compulsory psychiatric care law reform in between.

Experience of at least one coercive measure was more common amongst patients who had been committed during the most recent legislation. Otherwise there were no differences in patient experiences during the different laws.

Subjective short-term outcome was associated with having a contact person at the ward and being subjectively treated well. There were no relationships between subjective and assessed outcome or between legal status, perceived coercion at admission and subjective or assessed improvement.

The changed legislation had no clear effect on the attitudes of patients and next of kins towards coercion.

A majority of patients were able to accurately answer the question whether they had been restrained by belt or not during a specific treatment episode. Nineteen of 115 patients reported they had been restrained by belt. Eleven of these cases were true positive and 8 cases were false positive.

In conclusion, the main results were first that when it comes to issues related to psychiatric coercion there are typically considerable differences between how these are perceived and interpreted by the professional and by the patient, and second that efforts made to change the face of psychiatric coercion in the minds of patients as well as the public on part of public policymakers have had limited effects.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2008. 63 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 326
Keyword
Psychiatry, attitudes, coercion, coercive measures, commitment of mentally ill, compulsory psychiatric care, inpatient treatment, next of kins, patients, restraint, self-report, Psykiatri
Identifiers
urn:nbn:se:uu:diva-8607 (URN)978-91-554-7149-1 (ISBN)
Public defence
2008-04-18, Samlingssalen, Psykiatricentrum, Ing. 29, Centrallasarettet, 721 89 Västerås, 13:15
Opponent
Supervisors
Available from: 2008-03-28 Created: 2008-03-28Bibliographically approved

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