Sources of coercive behaviours in psychiatric admissions.
OBJECTIVE
Coercion during psychiatric admissions has been a topic of debate for many years. Although there has been considerable research on patients' perceptions of coercion, there has been no work on who places pressures on patients to be admitted.


METHODS
This article integrates interview data from interviews with patients, admitting staff and family and friends to describe the pressures brought to bear on patients to be admitted.


RESULTS
Health-care professionals appear to be the most important source of pressures on patients, and to have the most impact on patients' perceptions of coercion. However, there are differences in type of pressure, and the pressures used by family and friends appear to have the most longstanding impact.


CONCLUSIONS
Legal and clinical efforts to reduce the level of coercive pressures on patients need to recognize the importance of mental-health professionals, including especially those who are not legally mandated to participate in the admission process.
Lidz
C W
CW
Department of Psychiatry, University of Massachusetts Medical School, Worcester 01655, USA.
Mulvey
E P
EP
Hoge
S K
SK
Kirsch
B L
BL
Monahan
J
J
Bennett
N S
NS
Eisenberg
M
M
Gardner
W
W
Roth
L H
LH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D010054:Brief Psychiatric Rating Scale / Q000706:statistics & numerical data; D003068:Coercion; D005190:Family; D005500:Follow-Up Studies; D005555:Forensic Psychiatry; D006778:Hospitals, Psychiatric; D006801:Humans; D007398:Interpersonal Relations; D001523:Mental Disorders / Q000523:psychology* / Q000628:therapy*; D008875:Middle Aged; D010343:Patient Admission; D010344:Patient Advocacy; D010414:Pennsylvania; D010564:Personnel, Hospital; D016495:Police; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D013637:Tape Recording; D014768:Virginia