title: Perceived coercion in voluntary hospital admission.
abstract: The legal status of service users admitted to psychiatric wards is not synonymous with the level of coercion that they can perceive during the admission. This study aimed to identify and describe the proportion of individuals who were admitted voluntarily but experienced levels of perceived coercion comparable to those admitted involuntarily. Individuals admitted voluntarily and involuntarily to three psychiatric hospitals were interviewed using the MacArthur Admission Experience Interview and the Structured Clinical Interview for DSM-IV diagnoses. One hundered sixty-one individuals were interviewed and 22% of the voluntarily admitted service users had levels of perceived coercion similar to that of the majority of involuntarily admitted service users. Voluntarily admitted service users who experienced high levels of perceived coercion were more likely to have more severe psychotic symptoms, have experienced more negative pressures and less procedural justices on admission. Individuals brought to hospital under mental health legislation but who subsequently agreed to be admitted voluntarily and those treated on a secure ward also reported higher levels of perceived coercion. It needs to be ensured that if any service user, whether voluntary or involuntary, experiences treatment pressures or coercion that there is sufficient oversight of the practice, to ensure that individual's rights are respected.
authors.affiliation: Department of General Adult Psychiatry, Cluain Mhuire Mental Health Service, Newtownpark Avenue, Blackrock, Dublin, Ireland. Electronic address: briannoelodonoghue@gmail.com.
authors.forename: Brian
authors.initials: B
authors.lastname: O'Donoghue
authors.affiliation: Department of General Adult Psychiatry, Cluain Mhuire Mental Health Service, Newtownpark Avenue, Blackrock, Dublin, Ireland.
authors.forename: Eric
authors.initials: E
authors.lastname: Roche
authors.affiliation: Mental Health Commission, Waterloo Road, Dublin, Ireland; Department of Psychiatry, Royal College of Surgeons, Ireland.
authors.forename: Stephen
authors.initials: S
authors.lastname: Shannon
authors.affiliation: St Vincents University Hospital, Elm Park, Dublin 4, Ireland; DETECT Early Intervention for Psychosis Service, Blackrock, Co Dublin, Ireland.
authors.forename: John
authors.initials: J
authors.lastname: Lyne
authors.affiliation: Department of General Adult Psychiatry, Cluain Mhuire Mental Health Service, Newtownpark Avenue, Blackrock, Dublin, Ireland; DETECT Early Intervention for Psychosis Service, Blackrock, Co Dublin, Ireland.
authors.forename: Kevin
authors.initials: K
authors.lastname: Madigan
authors.affiliation: Department of General Adult Psychiatry, Cluain Mhuire Mental Health Service, Newtownpark Avenue, Blackrock, Dublin, Ireland; Department of Psychiatry, Royal College of Surgeons, Ireland.
authors.forename: Larkin
authors.initials: L
authors.lastname: Feeney
mesh_terms: D000328:Adult; D003068:Coercion; D005260:Female; D006778:Hospitals, Psychiatric; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D010343:Patient Admission; D010465:Perception; D011567:Psychiatric Department, Hospital; D011618:Psychotic Disorders / Q000523:psychology / Q000628:therapy*
keywords: Coercion; Ethics; Involuntary commitment; Psychosis; Voluntary admission