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A qualitative integrative analysis of service users’ and service providers’ perspectives on ways to reduce coercion in mental health care

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Abstract

Purpose

The movement to develop and implement non-coercive alternatives in the provision of mental health care is gaining momentum globally. To strengthen the basis of potential interventions that will be contextually relevant, and to complement the body of literature which is largely from high-income settings, the current study sought to explore the suggestions of service users and providers in Nigeria on how to reduce the use of coercive measures in mental health settings.

Methods

Semi-structured interviews with 30 mental health professionals and four focus group discussions among 30 service users from two psychiatric hospitals in Nigeria were conducted. The data were analyzed thematically with the aid of MAXQDA.

Results

The suggestions proposed by service users and mental health professionals were within the broad themes of communication, policies and legislation, and increased resources. Service users felt that improved communication, home consultations, non-legal advocates and clear rules and legislation would reduce the use of coercion, while service providers suggested increased public mental health literacy, better interpersonal relationships with patients, increased resources for mental health care, more research on the topic and regulation of coercive measures.

Conclusion

Many of the suggestions from this study reinforce strategies already in place to decrease coercion in other settings. However, additional recommendations that are relevant to the study setting, such as enhancing public mental health literacy, mental health legislation reform and increasing access to mental health services, deserve further consideration.

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Data availability

The data analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors gratefully acknowledge the study participants who generously shared their time for this study.

Funding

Deborah Oyine Aluh is a PhD student receiving the support of a PhD fellowship from” la Caixa” Foundation (LCF/BQ/DI20/11780013). Barbara Pedrosa and Ugnė Grigaitė are PhD students receiving financial support from the FCT – Fundação para a Ciência e a Tecnologia (UI/BD/151073/2021 and UI/BD/151072/2021).

Author information

Authors and Affiliations

  1. Lisbon Institute of Global Mental Health, Lisbon, Portugal

    Deborah Oyine Aluh, Barbara Pedrosa, Manuela Silva, Ugnė Grigaitė, Margarida Dias, Graça Cardoso & José Miguel Caldas-de-Almeida

  2. NOVA Medical School, Comprehensive Health Research Centre (chrc), NOVA University of Lisbon, Lisbon, Portugal

    Deborah Oyine Aluh, Barbara Pedrosa, Manuela Silva, Ugnė Grigaitė, Margarida Dias, Graça Cardoso & José Miguel Caldas-de-Almeida

  3. Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, Nsukka, Nigeria

    Deborah Oyine Aluh

  4. Department of Mental Health, Faculty of Medicine, Nnamdi Azikiwe University, Nnewi Campus, Awka, Anambra State, Nigeria

    Justus Uchenna Onu

  5. Department of Clinical Services, Federal Neuropsychiatric Hospital, Uselu, Edo State, Nigeria

    Olaniyi Ayilara

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  1. Deborah Oyine Aluh
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  2. Justus Uchenna Onu
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  3. Olaniyi Ayilara
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  4. Barbara Pedrosa
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  6. Ugnė Grigaitė
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  9. José Miguel Caldas-de-Almeida
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Contributions

DOA conceptualized the study, performed the design of the study, carried out the data analyses and drafted the manuscript. OA and JUO contributed in the study design, recruitment of participants, data collection, analyses and manuscript draft. BP, MS, UG, MD and GC made contributions to the manuscript draft. JMCA contributed to the conceptualization, study design and manuscript draft. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Deborah Oyine Aluh.

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The authors declare no conflicts of interest.

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Aluh, D.O., Onu, J.U., Ayilara, O. et al. A qualitative integrative analysis of service users’ and service providers’ perspectives on ways to reduce coercion in mental health care. Soc Psychiatry Psychiatr Epidemiol 58, 1353–1363 (2023). https://doi.org/10.1007/s00127-023-02435-x

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