Treatment pressures, leverage, coercion, and compulsion in mental health care

  title={Treatment pressures, leverage, coercion, and compulsion in mental health care},
  author={George I. Szmukler and Paul S. Appelbaum},
  journal={Journal of Mental Health},
  pages={233 - 244}
Background: Questions concerning non-consensual treatment in mental health services have assumed an increased salience. In significant part, this has been due to changes in professional practice, as well as the perceived risks, associated with the movement of treatment from hospital to community. Aims: To define the main forms of pressure aimed at inducing reluctant patients to accept treatment and to examine frameworks for their justification. Method: Review of the literature on “coercion… 

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Patients often felt inferior, while many of the staff felt guilty for violating patients’ dignity, although they ascribed responsibility for their actions to the “system,” and there are divergent views of coercion.

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The existing body of literature indicates that psychiatric service-users commonly experience treatment pressures. In the research to date there has been a bias towards investigating (often



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Patients' feelings of being coerced concerning admission appears to be closely related to their sense of procedural justice, and clinicians can minimize the experience of coercion even among those legally committed by attending more closely to procedural justice issues.

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  • 2003
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