title: Informal coercion in psychiatry: a focus group study of attitudes and experiences of mental health professionals in ten countries.
abstract: OBJECTIVE
  Whilst formal coercion in psychiatry is regulated by legislation, other interventions that are often referred to as informal coercion are less regulated. It remains unclear to what extent these interventions are, and how they are used, in mental healthcare. This paper aims to identify the attitudes and experiences of mental health professionals towards the use of informal coercion across countries with differing sociocultural contexts.
  
  
  METHODS
  Focus groups with mental health professionals were conducted in ten countries with different sociocultural contexts (Canada, Chile, Croatia, Germany, Italy, Mexico, Norway, Spain, Sweden, United Kingdom).
  
  
  RESULTS
  Five common themes were identified: (a) a belief that informal coercion is effective; (b) an often uncomfortable feeling using it; (c) an explicit as well as (d) implicit dissonance between attitudes and practice-with wider use of informal coercion than is thought right in theory; (e) a link to principles of paternalism and responsibility versus respect for the patient's autonomy.
  
  
  CONCLUSIONS
  A disapproval of informal coercion in theory is often overridden in practice. This dissonance occurs across different sociocultural contexts, tends to make professionals feel uneasy, and requires more debate and guidance.
authors.affiliation: Department of Medical Specialties, Psychology and Pedagogy Applied, School of Biomedical Sciences, Universidad Europea de Madrid, Campus Villaviciosa de Odón, Madrid, Spain.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Valenti
authors.forename: Ciara
authors.initials: C
authors.lastname: Banks
authors.forename: Alfredo
authors.initials: A
authors.lastname: Calcedo-Barba
authors.forename: Cécile M
authors.initials: CM
authors.lastname: Bensimon
authors.forename: Karin-Maria
authors.initials: KM
authors.lastname: Hoffmann
authors.forename: Veikko
authors.initials: V
authors.lastname: Pelto-Piri
authors.forename: Tanja
authors.initials: T
authors.lastname: Jurin
authors.forename: Octavio Márquez
authors.initials: OM
authors.lastname: Mendoza
authors.forename: Adrian P
authors.initials: AP
authors.lastname: Mundt
authors.forename: Jorun
authors.initials: J
authors.lastname: Rugkåsa
authors.forename: Jacopo
authors.initials: J
authors.lastname: Tubini
authors.forename: Stefan
authors.initials: S
authors.lastname: Priebe
mesh_terms: D000328:Adult; D002170:Canada; D002677:Chile; D003068:Coercion; D005060:Europe; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000706:statistics & numerical data*; D006801:Humans; D038622:Internationality; D008137:Longitudinal Studies; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008800:Mexico; D026706:Paternalism; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011568:Psychiatric Nursing / Q000379:methods / Q000706:statistics & numerical data; D011570:Psychiatry / Q000379:methods* / Q000706:statistics & numerical data; D011586:Psychology, Clinical / Q000379:methods / Q000706:statistics & numerical data; D012947:Social Work / Q000379:methods / Q000706:statistics & numerical data