Skip to main content

Advertisement

Springer Nature Link
Log in

Investigating the impact of involuntary psychiatric hospitalization on youth and young adult trust and help-seeking in pathways to care

  • Original Paper
  • Published:
Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Purpose

Few studies have focused on the experience of involuntary psychiatric hospitalization among youth, especially the impact of these experiences on engagement with mental health services post-discharge. In this study, we contribute to a deeper understanding of youth experiences of involuntary hospitalization (IH) and its subsequent impacts on trust, help-seeking, and engagement with clinicians.

Methods

The study utilized a grounded theory approach, conducting in-depth interviews with 40 youth and young adults (ages 16–27) who had experienced at least one prior involuntary hospitalization.

Results

Three quarters of the youth reported negative impacts of IH on trust, including unwillingness to disclose suicidal feelings or intentions. Selective non-disclosure of suicidal feelings was reported even in instances in which the participant continued to meet with providers following discharge. Factors identified as contributing to distrust included perceptions of inpatient treatment as more punitive than therapeutic, staff as more judgmental than empathetic, and hospitalization overall failing to meet therapeutic needs. Conversely, participants reporting more mixed experiences of hospitalization and simultaneously strong indirect benefits, including greater family support, diminished family judgement members and greater access to care.

Conclusion

Findings draw attention to the ways in which coercive experiences may impact youth pathways to and through care. Additional research is needed to understand the impact of these experiences across larger samples, and their influence on downstream outcomes including engagement and long-term wellbeing. Finally, these data may inform the development and testing of inpatient and post-discharge interventions designed to mitigate potential harm.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
€32.70 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price includes VAT (Netherlands)

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Data availability

Due to methodology (in depth interviews) ethics permissions do not permit transcript sharing.

References

  1. MacDonald K, Fainman-Adelman N, Anderson KK, Iyer SN (2018) Pathways to mental health services for young people: a systematic review. Soc Psychiatry Psychiatr Epidemiol 53:1005–1038

    Article  PubMed  PubMed Central  Google Scholar 

  2. McGorry P, Bates T, Birchwood M (2013) Designing youth mental health services for the 21st century: examples from Australia, Ireland and the UK. Brit J Psychiat 202:s30–s35

    Article  Google Scholar 

  3. McGorry PD, Mei C (2018) Tackling the youth mental health crisis across adolescence and young adulthood. BMJ 362:k3704

    Article  PubMed  Google Scholar 

  4. Narendorf SC, Munson MR, Washburn M, Fedoravicius N, Wagner R, Flores SK (2017) Symptoms, circumstances, and service systems: pathways to psychiatric crisis service use among uninsured young adults. Am J Orthopsychiatry 87:585–596. https://doi.org/10.1037/ort0000218

    Article  PubMed  Google Scholar 

  5. Anderson T, Patterson CL, McClintock AS, Song X (2013) Factorial and predictive validity of the expectations about counseling-brief (EAC-B) with clients seeking counseling. J Couns Psychol 60:496–507. https://doi.org/10.1037/a0034222

    Article  PubMed  Google Scholar 

  6. Bhui K, Stansfeld S, Hull S, Priebe S, Mole F, Feder G (2003) Ethnic variations in pathways to and use of specialist mental health services in the UK: systematic review. Brit J Psychiat 182:105–116

    Article  PubMed  Google Scholar 

  7. Morgan C, Mallett R, Hutchinson G, Leff J (2004) Negative pathways to psychiatric care and ethnicity: the bridge between social science and psychiatry. Soc Sci Med 58:739–752

    Article  PubMed  Google Scholar 

  8. Opjordsmoen S, Friis S, Melle I, Haahr U, Johannessen JO, Larsen TK, Røssberg JI, Rund BR, Simonsen E, Vaglum P (2010) A 2-year follow-up of involuntary admission’s influence upon adherence and outcome in first-episode psychosis. Acta Psychiatr Scand 121:371–376

    Article  CAS  PubMed  Google Scholar 

  9. Mueser KT, Lu W, Rosenberg SD, Wolfe R (2010) The trauma of psychosis: posttraumatic stress disorder and recent onset psychosis. Schizophr Res 116:217–227

    Article  PubMed  Google Scholar 

  10. Rodrigues R, Anderson KK (2017) The traumatic experience of first-episode psychosis: a systematic review and meta-analysis. Schizophr Res 189:27–36

    Article  PubMed  Google Scholar 

  11. O’Donoghue B, Lyne J, Hill M, Larkin C, Feeney L, O’Callaghan E (2010) Involuntary admission from the patients’ perspective. Soc Psychiatry Psychiatr Epidemiol 45:631–638

    Article  PubMed  Google Scholar 

  12. Priebe S, Katsakou C, Amos T, Leese M, Morriss R, Rose D, Wykes T, Yeeles K (2009) Patients’ views and readmissions 1 year after involuntary hospitalisation. Brit J Psychiat 194:49–54

    Article  PubMed  Google Scholar 

  13. Priebe S, Katsakou C, Glöckner M, Dembinskas A, Fiorillo A, Karastergiou A, Kiejna A, Kjellin L, Nawka P, Onchev G (2010) Patients’ views of involuntary hospital admission after 1 and 3 months: prospective study in 11 European countries. Brit J Psychiat 196:179–185

    Article  PubMed  Google Scholar 

  14. Bindman J, Reid Y, Szmukler G, Tiller J, Thornicroft G, Leese M (2005) Perceived coercion at admission to psychiatric hospital and engagement with follow-up. Soc Psychiatry Psychiatr Epidemiol 40:160–166

    Article  PubMed  Google Scholar 

  15. Steinert T, Schmid P (2004) Effect of voluntariness of participation in treatment on short-term outcome of inpatients with schizophrenia. Psychiatr Serv 55:786–791

    Article  PubMed  Google Scholar 

  16. Rain SD, Williams VF, Robbins PC, Monahan J, Steadman HJ, Vesselinov R (2003) Perceived coercion at hospital admission and adherence to mental health treatment after discharge. Psychiatr Serv 54:103–105

    Article  PubMed  Google Scholar 

  17. Jaeger S, Pfiffner C, Weiser P, Längle G, Croissant D, Schepp W, Kilian R, Becker T, Eschweiler G, Steinert T (2013) Long-term effects of involuntary hospitalization on medication adherence, treatment engagement and perception of coercion. Soc Psychiatry Psychiatr Epidemiol 48:1787–1796

    Article  PubMed  Google Scholar 

  18. Strauss JL, Zervakis JB, Stechuchak KM, Olsen MK, Swanson J, Swartz MS, Weinberger M, Marx CE, Calhoun PS, Bradford DW (2013) Adverse impact of coercive treatments on psychiatric inpatients’ satisfaction with care. Community Ment Health J 49:457–465

    Article  PubMed  Google Scholar 

  19. Katsakou C, Priebe S (2006) Outcomes of involuntary hospital admission–a review. Acta Psychiatr Scand 114:232–241

    Article  CAS  PubMed  Google Scholar 

  20. Katsakou C, Bowers L, Amos T, Morriss R, Rose D, Wykes T, Priebe S (2010) Coercion and treatment satisfaction among involuntary patients. Psychiatr Serv 61:286–292

    Article  PubMed  Google Scholar 

  21. Link B, Castille DM, Stuber J (2008) Stigma and coercion in the context of outpatient treatment for people with mental illnesses. Soc Sci Med 67:409–419

    Article  PubMed  Google Scholar 

  22. Gault I, Gallagher A, Chambers M (2013) Perspectives on medicine adherence in service users and carers with experience of legally sanctioned detention and medication: a qualitative study. Patient Prefer Adherence 7:787

    Article  PubMed  PubMed Central  Google Scholar 

  23. Newton-Howes G, Mullen R (2011) Coercion in psychiatric care: systematic review of correlates and themes. Psychiatr Serv 62(5):465–470

    Article  PubMed  Google Scholar 

  24. Hughes R, Hayward M, Finlay W (2009) Patients’ perceptions of the impact of involuntary inpatient care on self, relationships and recovery. J Ment Health 18:152–160

    Article  Google Scholar 

  25. Akther SF, Molyneaux E, Stuart R, Johnson S, Simpson A, Oram S (2019) Patients’ experiences of assessment and detention under mental health legislation: systematic review and qualitative meta-synthesis. BJPsych Open 5:e37

    Article  PubMed  PubMed Central  Google Scholar 

  26. Chung DT, Ryan CJ, Hadzi-Pavlovic D, Singh SP, Stanton C, Large MM (2017) Suicide rates after discharge from psychiatric facilities: a systematic review and meta-analysis. JAMA Psychiatr 74:694–702

    Article  Google Scholar 

  27. Ward-Ciesielski EF, Rizvi SL (2020) The potential iatrogenic effects of psychiatric hospitalization for suicidal behavior: a critical review and recommendations for research. Clin Psychol. https://doi.org/10.1111/cpsp.12332

    Article  Google Scholar 

  28. Borecky TC, Dubov A (2019) Reweighing the ethical tradeoffs in the involuntary hospitalization of suicidal patients. Am J Bioeth 19:71–83

    Article  PubMed  Google Scholar 

  29. Jordan JT, McNiel DE (2020) Perceived coercion during admission into psychiatric hospitalization increases risk of suicide attempts after discharge. Suicide Life Threat Behav 50:180–188

    Article  PubMed  Google Scholar 

  30. Large MM, Kapur N (2018) Psychiatric hospitalisation and the risk of suicide. Brit J Psychiat 212:269–273

    Article  PubMed  Google Scholar 

  31. Seed T, Fox JR, Berry K (2016) The experience of involuntary detention in acute psychiatric care. A review and synthesis of qualitative studies. Int J Nurs Stud 61:82–94

    Article  PubMed  Google Scholar 

  32. Weller BE, Faulkner M, Doyle O, Daniel SS, Goldston DB (2015) Impact of patients’ psychiatric hospitalization on caregivers: a systematic review. Psychiatr Serv 66:527–535

    Article  PubMed  PubMed Central  Google Scholar 

  33. Chen A, Dinyarian C, Inglis F, Chiasson C, Cleverley K (2020) Discharge interventions from inpatient child and adolescent mental health care: a scoping review. Eur Child Adol Psychiatry. https://doi.org/10.1007/s00787-020-01634-0

    Article  Google Scholar 

  34. Fontanella CA, Hiance-Steelesmith DL, Bridge JA, Lester N, Sweeney HA, Hurst M, Campo JV (2016) Factors associated with timely follow-up care after psychiatric hospitalization for youths with mood disorders. Psychiatr Serv 67:324–331

    Article  PubMed  Google Scholar 

  35. Smith CP (2017) First, do no harm: institutional betrayal and trust in health care organizations. J Multidiscip Healthc 10:133

    Article  PubMed  PubMed Central  Google Scholar 

  36. Smith CP, Freyd JJ (2013) Dangerous safe havens: institutional betrayal exacerbates sexual trauma. J Traum Stress 26:119–124

    Article  Google Scholar 

  37. Robins CS, Sauvageot JA, Cusack KJ, Suffoletta-Maierle S, Frueh BC (2005) Special section on seclusion and restraint: consumers’ perceptions of negative experiences and" Sanctuary Harm" in psychiatric settings. Psychiatr Serv 56:1134–1138

    Article  PubMed  Google Scholar 

  38. Frueh BC, Dalton ME, Johnson MR, Hiers TG, Gold PB, Magruder KM, Santos AB (2000) Trauma within the psychiatric setting: conceptual framework, research directions, and policy implications. Adm Policy Ment Health 28:147–154

    Article  CAS  PubMed  Google Scholar 

  39. Cusack KJ, Frueh BC, Hiers T, Suffoletta-Maierle S, Bennett S (2003) Trauma within the psychiatric setting: a preliminary empirical report. Adm Policy Ment Health 30:453–460

    Article  PubMed  Google Scholar 

  40. Moses T (2011) Stigma apprehension among adolescents discharged from brief psychiatric hospitalization. J Nerv Ment Dis 199:778–789

    Article  PubMed  Google Scholar 

  41. Swartz MS, Swanson JW, Hannon MJ (2003) Does fear of coercion keep people away from mental health treatment? Evidence from a survey of persons with schizophrenia and mental health professionals. Behav Sci Law 21:459–472

    Article  PubMed  Google Scholar 

  42. Edwards D, Evans N, Gillen E, Longo M, Pryjmachuk S, Trainor G, Hannigan B (2015) What do we know about the risks for young people moving into, through and out of inpatient mental health care? Findings from an evidence synthesis. Child Adolesc Psychiatry Ment Health 9:1–17

    Article  Google Scholar 

  43. Charmaz K (2006) Constructing grounded theory: a practical guide through qualitative analysis. Sage, Thousand Oaks

    Google Scholar 

  44. Strauss A, Corbin JM (1997) Grounded theory in practice. Sage, Thousand Oaks

    Google Scholar 

  45. Strauss A, Corbin J (1990) Basics of qualitative research. Sage, Thousand Oaks

    Google Scholar 

  46. Christy A, Rhode S, Lersch K, Ringhoff D, Jenkins K (2019) Baker Act Reporting Center 17/18 Annual Report. https://www.usf.edu/cbcs/baker-act/documents/ba_usf_annual_report_2017_2018.pdf. Accessed 19 Jul 2020

  47. Lee G, Cohen D (2021) Incidences of involuntary psychiatric detentions in 25 US states. Psychiatr Serv 72:61–68

    Article  PubMed  Google Scholar 

  48. Prebble K, Thom K, Hudson E (2015) Service Users’ experiences of voluntary admission to mental hospital: a review of research literature. Psychiatr Psychol Law 22:327–336

    Article  Google Scholar 

  49. Galon PA, Wineman NM (2010) Coercion and procedural justice in psychiatric care: State of the science and implications for nursing. Arch Psychiatr Nurs 24(5):307–316

    Article  PubMed  Google Scholar 

  50. Theodoridou A, Schlatter F, Ajdacic V, Rössler W, Jäger M (2012) Therapeutic relationship in the context of perceived coercion in a psychiatric population. Psychiatry Res 200:939–944

    Article  PubMed  Google Scholar 

  51. Tapp JL, Levine FJ (1974) Legal socialization: strategies for an ethical legality. Stan L Rev 27:1

    Article  Google Scholar 

  52. Trinkner R, Tyler TR (2016) Legal socialization: coercion versus consent in an era of mistrust. Annu Rev Law Soc Sci 12:417–439

    Article  Google Scholar 

  53. Livingston JD, Boyd JE (2010) Correlates and consequences of internalized stigma for people living with mental illness: a systematic review and meta-analysis. Soc Sci Med 71:2150–2161

    Article  PubMed  Google Scholar 

  54. Lal S, Malla A (2015) Service engagement in first-episode psychosis: current issues and future directions. Can J Psychiatry 60:341–345

    Article  PubMed  PubMed Central  Google Scholar 

  55. Kim H, Munson MR, McKay MM (2012) Engagement in mental health treatment among adolescents and young adults: a systematic review. Child Adolesc Social Work J 29:241–266

    Article  Google Scholar 

  56. Munson MR, Scott LD Jr, Smalling SE, Kim H, Floersch JE (2011) Former system youth with mental health needs: routes to adult mental health care, insight, emotions, and mistrust. Child Youth Serv Rev 33:2261–2266

    Article  Google Scholar 

  57. Jayawickreme E, Blackie LE (2014) Post-traumatic growth as positive personality change: evidence, controversies and future directions. Eur J Personality 28:312–331

    Article  Google Scholar 

  58. Manley E, Schober M, Simons D, Zabel M (2018) Making the case for a comprehensive children’s crisis continuum of care. National Association of State Mental Health Program Directors Publishing, Alexandria

    Google Scholar 

  59. LeCloux M, Maramaldi P, Thomas K, Wharff E (2016) Family support and mental health service use among suicidal adolescents. J Child Fam Stud 25:2597–2606

    Article  Google Scholar 

  60. Waid J, Kelly M (2020) Supporting family engagement with child and adolescent mental health services: a scoping review. Health Soc Care Community. https://doi.org/10.1111/hsc.12947

    Article  PubMed  Google Scholar 

  61. Baker A, Lewin T, Reichler H, Clancy R, Carr V, Garrett R, Sly K, Devir H, Terry M (2002) Evaluation of a motivational interview for substance use within psychiatric in-patient services. Addiction 97:1329–1337

    Article  PubMed  Google Scholar 

  62. Gibbons J, Plath D (2009) Single contacts with hospital social workers: the clients’ experiences. Soc Work Health Care 48:721–735

    Article  PubMed  Google Scholar 

  63. Munson MR, Jaccard JJ, Scott LD Jr, Narendorf SC, Moore KL, Jenefsky N, Cole A, Davis M, Gilmer T, Shimizu R, Pleines K (2020) Engagement intervention versus treatment as usual for young adults with serious mental illness: a randomized pilot trial. Pilot Feasibility Stud 6:1–14

    Article  Google Scholar 

  64. Turnbull JE, Galinsky MJ, Wilner ME, Meglin DE (1994) Designing research to meet service needs: an evaluation of single-session groups for families of psychiatric inpatients. Res Soc Work Pract 4:192–207

    Article  Google Scholar 

  65. Kidd SA, McKenzie KJ, Virdee G (2014) Mental health reform at a systems level: widening the lens on recovery-oriented care. Can J Psychiatry 59:243–249

    Article  PubMed  PubMed Central  Google Scholar 

  66. Tsai J, Salyers MP (2010) Recovery orientation in hospital and community settings. J Behav Health Serv Res 37:385–399

    Article  PubMed  Google Scholar 

  67. Shields MC, Stewart MT, Delaney KR (2018) Patient safety in inpatient psychiatry: a remaining frontier for health policy. Health Aff 37:1853–1861

    Article  Google Scholar 

  68. Abma TA, Voskes Y, Widdershoven G (2017) Participatory bioethics research and its social impact: the case of coercion reduction in psychiatry. Bioethics 31:144–152

    Article  PubMed  Google Scholar 

  69. Hui K, Cooper RB, Zaheer J (2020) Engaging patients and families in the ethics of involuntary psychiatric care. Am J Bioeth 20:82–84

    Article  PubMed  Google Scholar 

Download references

Funding

[University De-identified] New Investigator Award to the First Author.

Author information

Authors and Affiliations

  1. Department of Psychiatry and Behavioral Neurosciences, University of South Florida, 4202 East Fowler Ave, Tampa, FL, 33620, USA

    Nev Jones

  2. Department of Psychology, University of South Florida, Tampa, FL, USA

    Becky K. Gius

  3. Department of Psychiatry, Center for Mental Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Morgan Shields

  4. Leonard Davis Institute of Health Economics, Philadelphia, PA, USA

    Morgan Shields

  5. Department of Counseling, Troy University, Tampa, FL, USA

    Shira Collings

  6. Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA

    Cherise Rosen

  7. Silver School of Social Work, New York University, New York, NY, USA

    Michelle Munson

Authors
  1. Nev Jones
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Becky K. Gius
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Morgan Shields
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shira Collings
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Cherise Rosen
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Michelle Munson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nev Jones.

Ethics declarations

Conflict of interest

Authors report no conflicts of interest.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 17 KB)

Supplementary file2 (PDF 37 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Jones, N., Gius, B.K., Shields, M. et al. Investigating the impact of involuntary psychiatric hospitalization on youth and young adult trust and help-seeking in pathways to care. Soc Psychiatry Psychiatr Epidemiol 56, 2017–2027 (2021). https://doi.org/10.1007/s00127-021-02048-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00127-021-02048-2

Keywords

Search

Navigation