Coercion experience of patients with mental illness in a tertiary care hospital in Kerala
DOI:
https://doi.org/10.30834/KJP.35.2.2023.342Keywords:
Mental illness, admission, coercive experiencesAbstract
Background: Coercion is a negative experience that interferes with the basic freedom and rights of patients with mental illness. The present study focuses on understanding the experience of coercion in patients with mental illness during their admission to a tertiary care hospital. Objectives: The study aims to assess the coercion experience of patients with mental illness who are undergoing treatment from a teaching hospital in a northern district of Kerala. The study also looked into the relationship between coercion experience and socio-demographic variables. Methods: A semi-structured interview schedule to assess socio-demographic variables and MacArthur Admission Experience Survey to assess the coercion experience of patients with mental illness were used in this study. The study sample included 84 patients with mental illness who had admission experience in the last two years. Results: Findings of the study revealed that 36.9% of patients with mental illness experienced high coercion and another 29.8% reported a moderate level of coercion. Affective reactions to hospitalization showed confusion (48.80%) and sadness (40.48%). A significant negative correlation was established between coercion experience and age, drug compliance and age of onset of illness. There was no significant relationship between coercion experience and sex, marital status, religion, socio-economic status, educational status, occupational status, diagnosis category, place of residence and regularity of treatment. Conclusion: A significant proportion of patients report coercive experiences during their admission for psychiatric treatment. Coercion is a negative experience that adversely affects the outcome. The study is attempting to highlight whether there is a need to lessen coercion
Downloads
References
Chieze M, Clavien C, Kaiser S, Hurst S. Coercive measures in psychiatry: a review of ethical arguments. Front Psychiatry 2021;12:790886. DOI: 10.3389/fpsyt.2021.790886
Wertheimer A. A philosophical examination of coercion for mental health issues. Behav Sci Law 1993;11:239–58.
Duffy RM, Kelly BD. The right to mental healthcare: India moves forward. Br J Psychiatry 2019;214:59–60.
Mielau J, Altunbay J, Gallinat J, Heinz A, Bermpohl F, Lehmann A, et al. Subjective experience of coercion in psychiatric care: a study comparing the attitudes of patients and healthy volunteers towards coercive methods and their justification. Eur Arch Psychiatry Clin Neurosci 2016;266:337–47.
Szmukler G. Compulsion and “coercion” in mental health care. World Psychiatry 2015;14:259-61.
Szmukler G, Daw R, Callard F. Mental health law and the UN Convention on the rights of persons with disabilities. Int J Law Psychiatry 2014;37:245–52.
Luciano M, Sampogna G, Del Vecchio V, Pingani L, Palumbo C, De Rosa C, et al. Use of coercive measures in mental health practice and its impact on outcome: a critical review. Expert Rev Neurother 2014;14:131–41.
Sashidharan SP, Mezzina R, Puras D. Reducing coercion in mental healthcare. Epidemiol Psychiatr Sci 2019;28:605-12.
Mann K, Gröschel S, Singer S, Breitmaier J, Claus S, Fani M, et al. Evaluation of coercive measures in different psychiatric hospitals: the impact of institutional characteristics. BMC Psychiatry 2021;21:419. DOI: 10.1186/s12888-021-03410-z.
Raveesh BN, Pathare S, Lepping P, Noorthoorn EO, Gowda GS, Bunders-Aelen JGF. Perceived coercion in persons with mental disorder in India: A cross-sectional study. Indian J Psychiatry. 2016;58(Suppl 2):S210-S220.
Wong AH, Ray JM, Rosenberg A, Crispino L, Parker J, McVaney C, et al. Experiences of individuals who were physically restrained in the emergency department. JAMA Netw Open 2020;3: e1919381. DOI: 10.1001/jamanetworkopen.2019.19381
Golay P, Semlali I, Beuchat H, Pomini V, Silva B, Loutrel L, et al. Perceived coercion in psychiatric hospital admission: Validation of the French-language version of the MacArthur Admission Experience Survey. BMC Psychiatry 2017;17: 57. DOI: 10.1186/s12888-017-1519-4.
Gardner W, Hoge SK, Bennett N, Roth LH, Lidz CW, Monahan J, et al. Two scales for measuring patients’ perceptions for coercion during mental hospital admission. Behav Sci Law 1993;11:307–21.
Fond G, Boyer L, Boucekine M, Aden LA, Schürhoff F, Tessier A, et al. Validation study of the Medication Adherence Rating Scale. Results from the FACE-SZ national dataset. Schizophr Res 2017;182:84–9.
Chadda RK, Sood M. General hospital psychiatry in India: History, scope, and future. Indian J Psychiatry 2018;60(Suppl 2):S258-S263.
Varatharajan D, Thankappan R, Jayapalan S. Assessing the performance of primary health centres under decentralized government in Kerala, India. Health Policy Plan 2004;19:41–51.
Daund M, Sonavane S, Shrivastava A, Desousa A, Kumawat S. Mental Hospitals in India: Reforms for the future. Indian J Psychiatry 2018;60(Suppl 2):S239-S247.
O’Brien AJ, Thom K. United Nations convention on the rights of persons with disabilities and its implications for compulsory treatment and mental health nursing. Int J Ment Health Nurs 2014;23(3):193–4.
Murthy RS. Mental health initiatives in India (1947-2010). Natl Med J India 2011;24:98–107.
Corrigan PW, Watson AC. Understanding the impact of stigma on people with mental illness. World Psychiatry. 2002;1:16-20.
Merayo-Sereno B, Fernández-Rivas A, de Oliveira-Silva KL, Sánchez-Andérez F-J, Sesma-Pardo E, Vivanco-González E, et al. The experience of parents faced with the admission of their adolescent to a child and adolescent psychiatric inpatient unit. A qualitative study with focus groups. Curr Psychol 2021;1–11. Available from: https://doi.org/10.1007/s12144-021-01901-6
Gilburt H, Rose D, Slade M. The importance of relationships in mental health care: A qualitative study of service users’ experiences of psychiatric hospital admission in the UK. BMC Health Serv Res 2008;8:92. DOI:10.1186/1472-6963-8-92
Goren S, Singh NN, Best AM. The aggression-coercion cycle: Use of seclusion and restraint in a child psychiatric hospital. J Child Fam Stud 1993;2:61–73.
Rueve ME, Welton RS. Violence and mental illness. Psychiatry (Edgmont). 2008;5:34-48.
Buckley PF. The role of typical and atypical antipsychotic medications in the management of agitation and aggression. J Clin Psychiatry 1999;60(Suppl 10):52–60.
Loots E, Goossens E, Vanwesemael T, Morrens M, Van Rompaey B, Dilles T. Interventions to improve medication adherence in patients with schizophrenia or bipolar disorders: A systematic review and meta-analysis. Int J Environ Res Public Health 2021;18:10213. DOI: 10.3390/ijerph181910213.
El-Mallakh P, Findlay J. Strategies to improve medication adherence in patients with schizophrenia: the role of support services. Neuropsychiatr Dis Treat. 2015;11:1077-90.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Anagha Unnikrishnan, T K Saleem, C A Smitha (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
