Social Psychiatry and Psychiatric Epidemiology

, Volume 50, Issue 8, pp 1297–1308 | Cite as

Informal coercion in psychiatry: a focus group study of attitudes and experiences of mental health professionals in ten countries

  • Emanuele Valenti
  • Ciara Banks
  • Alfredo Calcedo-Barba
  • Cécile M. Bensimon
  • Karin-Maria Hoffmann
  • Veikko Pelto-Piri
  • Tanja Jurin
  • Octavio Márquez Mendoza
  • Adrian P. Mundt
  • Jorun Rugkåsa
  • Jacopo Tubini
  • Stefan PriebeEmail author
Original Paper



Whilst formal coercion in psychiatry is regulated by legislation, other interventions that are often referred to as informal coercion are less regulated. It remains unclear to what extent these interventions are, and how they are used, in mental healthcare. This paper aims to identify the attitudes and experiences of mental health professionals towards the use of informal coercion across countries with differing sociocultural contexts.


Focus groups with mental health professionals were conducted in ten countries with different sociocultural contexts (Canada, Chile, Croatia, Germany, Italy, Mexico, Norway, Spain, Sweden, United Kingdom).


Five common themes were identified: (a) a belief that informal coercion is effective; (b) an often uncomfortable feeling using it; (c) an explicit as well as (d) implicit dissonance between attitudes and practice—with wider use of informal coercion than is thought right in theory; (e) a link to principles of paternalism and responsibility versus respect for the patient’s autonomy.


A disapproval of informal coercion in theory is often overridden in practice. This dissonance occurs across different sociocultural contexts, tends to make professionals feel uneasy, and requires more debate and guidance.


Autonomy Ethics International comparison Paternalism Sociocultural context 


Conflict of interest


Supplementary material

127_2015_1032_MOESM1_ESM.docx (14 kb)
Supplementary material 1 (DOCX 14 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Emanuele Valenti
    • 1
  • Ciara Banks
    • 2
  • Alfredo Calcedo-Barba
    • 3
  • Cécile M. Bensimon
    • 4
  • Karin-Maria Hoffmann
    • 5
  • Veikko Pelto-Piri
    • 6
    • 7
  • Tanja Jurin
    • 8
  • Octavio Márquez Mendoza
    • 9
  • Adrian P. Mundt
    • 2
    • 10
  • Jorun Rugkåsa
    • 11
  • Jacopo Tubini
    • 12
  • Stefan Priebe
    • 2
    Email author
  1. 1.Department of Medical Specialties, Psychology and Pedagogy Applied, School of Biomedical SciencesUniversidad Europea de MadridMadridSpain
  2. 2.Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Service Development)Queen Mary University of LondonLondonUK
  3. 3.Department of Psychiatry, Hospital Universitario Gregorio Marañón de MadridUniversidad Complutense de MadridMadridSpain
  4. 4.Joint Centre for BioethicsUniversity of TorontoTorontoCanada
  5. 5.Department of Psychiatry and PsychotherapyCharité Campus MitteBerlinGermany
  6. 6.School of Health and Medical Sciences, Psychiatric Research CentreÖrebro County CouncilÖrebroSweden
  7. 7.School of Health and Medical SciencesÖrebro UniversityÖrebroSweden
  8. 8.Faculty of Humanities and Social SciencesUniversity of ZagrebZagrebCroatia
  9. 9.Research Center in Medical SciencesUniversidad Autónoma del Estado de MéxicoTolucaMexico
  10. 10.Escuela de Medicina sede Puerto MonttUniversidad San SebastiánConcepciónChile
  11. 11.Health Services Research UnitAkershus University HospitalLørenskogNorway
  12. 12.Section of Psychiatry and Clinical Psychology, Department of Public Health and Community MedicineUniversitá degli Studi di VeronaVeronaItaly

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