Individuals' experiences of involuntary admissions and preserving control: qualitative study (original) (raw)

2018, BJPsych Open

BackgroundA theoretical model of individuals' experiences before, during and after involuntary admission has not yet been established.AimsTo develop an understanding of individuals' experiences over the course of the involuntary admission process.MethodFifty individuals were recruited through purposive and theoretical sampling and interviewed 3 months after their involuntary admission. Analyses were conducted using a Straussian grounded theory approach.ResultsThe ‘theory of preserving control’ (ToPC) emerged from individuals' accounts of how they adapted to the experience of involuntary admission. The ToPC explains how individuals manage to reclaim control over their emotional, personal and social lives and consists of three categories: ‘losing control’, ‘regaining control’ and ‘maintaining control’, and a number of related subcategories.ConclusionsInvoluntary admission triggers a multifaceted process of control preservation. Clinicians need to develop therapeutic approa...

Exploring severe mental health problems and involuntary admission to psychiatric hospital

2016

Volume I consists of three chapters. The first chapter is a systematic review exploring the factors associated with coercion in those who are involuntarily admitted to hospital. Those with psychosis, aggression and poor global functioning were some of the factors associated with a higher likelihood of experiencing coercion. The second chapter outlines an empirical research study exploring the experience of being detained under Section 136 of the Mental Health Act (1983, 2007) using Critical Incident Technique (Flanagan 1954, Butterfield, Borgen Maglio & Edmunson, 2009). The importance of meaningful human relationships was found to underpin many of the critical incidents. The third and final chapter is a public domain briefing document which provides a concise and accessible summary of both the systematic review and the empirical research study. Volume II consists of five chapters, each containing a Clinical Practice Report (CPR). The first report outlines the details of a 14 year ol...

Feeling safe with patient‐controlled admissions: A grounded theory study of the mental health patients' experiences

Journal of Clinical Nursing, 2020

AimTo develop a grounded theory of the patients' experiences with patient‐controlled admission.BackgroundResearch indicates a potential for involving patients in mental health care, but there is a need to develop and investigate new approaches in health services. Patient‐controlled admission is an option for patients with severe mental disorders to refer themselves for a brief hospital admission when needed and thus avoid the usual admission procedure.DesignClassic grounded theory with generation of a theory based on the constant comparative method for data collection and analysis.MethodsField observations and interviews with 26 mental health patients. The COREQ checklist was followed.ResultsWe found that patient‐controlled admission induced safety by providing faster access to help and thus preventing further deterioration of symptoms. Being self‐determined, achieving calmness and receiving care with support and guidance from professionals during admission contributed to the se...

Perceptions and Attitudes towards Involuntary Hospital Admissions of Psychiatric Patients

Introduction: Involuntary admissions to acute psychiatric units are one of the most ethically challenging practices in Psychiatry. However, published literature falls back in examining this area that touches patient’s rights and freedom. Objectives: To examine patients’, physicians’ and relatives’ attitudes towards involuntary hospitalization. Method: Authors searched PubMed and Medline for articles published in the last 15 years (between January 1999 and January 2014); choosing English-language articles of studies based on samples drawn from inpatients admitted on an involuntary basis. Results: Out of a total of (198) published papers in refereed journals, there were (n=36) articles, including four reviews and thirty three original research papers which met the inclusion criteria for our review. All (n=36) papers examined patients’, relatives’, and professionals’ attitudes towards involuntary admission and perception of coercion. Of the total publications, there were (n=12) research articles which solely examined patients’ perception of coercion. The “European multi-site research project on coercion in psychiatry” (EUNOMIA) research project has provided extensive evidence for the current status on patients’ attitudes towards involuntary hospitalization and coercion. Significant proportions of patients regarded that involuntary admission as justified. However, attitudes towards coercion appeared to be more complex, and patients’ attitudes varied between studies. In a number of studies, the diagnosis was the main predictor of the admission status. Conclusion: There is evidence that the majority of patients who initially perceived that they did not need hospitalization revised their belief after hospital discharge and reported that they had needed hospital treatment.

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