Psychiatric patients’ views on why their involuntary hospitalisation was right or wrong: a qualitative study
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To explore involuntary patients’ retrospective views on why their hospitalisation was right or wrong.
Involuntary patients were recruited from 22 hospitals in England and interviewed in-depth. The study drew on grounded theory and thematic analysis.
Most of the patients felt mentally unwell before admission and out of control during their treatment. Despite these common experiences, three groups of patients with distinct views on their involuntary hospitalisation were identified: those who believed that it was right, those who thought it was wrong and those with ambivalent views. Those with retrospectively positive views believed that hospitalisation ensured that they received treatment, averted further harm and offered them the opportunity to recover in a safe place. They felt that coercion was necessary, as they could not recognise that they needed help when acutely unwell. Those who believed that involuntary admission was wrong thought that their problems could have been managed through less coercive interventions, and experienced hospitalisation as an unjust infringement of their autonomy, posing a permanent threat to their independence. Patients with ambivalent views believed that they needed acute treatment and that hospitalisation averted further harm. Nonetheless, they thought that their problems might have been managed through less coercive community interventions or a shorter voluntary hospitalisation.
The study illustrates why some patients view their involuntary hospitalisation positively, whereas others believe it was wrong. This knowledge could inform the development of interventions to improve patients’ views and treatment experiences.
KeywordsCommitment of mentally ill Coercion Patient admission Inpatients Qualitative research
This study was funded by a Grant from the Department of Health, United Kingdom, Commission number 0230072. The researchers were independent from the funders and the views expressed in the publication are those of the authors and not necessarily those of the Department of Health. The funding source had no role in the study design and conduct of the study, data collection, management, data analysis, data interpretation, or writing of the report and preparation, review or approval of the manuscript. Til Wykes and Diana Rose acknowledge financial support from the National Institute for Health Research (NIHR) Specialist Biomedical Research Centre for Mental Health award to the South London and Maudsley NHS Foundation Trust and the Institute of Psychiatry, King’s College London. We are grateful to the Mental Health Research Network for supporting the project, and to all the interviewed patients and staff of the participating hospitals. We also thank all the researchers involved in data collection.
Conflict of interest
The authors declare that they have no conflict of interest.
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