title: A Cross Cultural Comparison of Attitude of Mental Healthcare Professionals Towards Involuntary Treatment Orders.
abstract: The purpose of this study was to investigate East-West cultural attitudes of mental healthcare professionals (MHPs) towards Involuntary Treatment Orders (ITOs) among Taiwan, England, Wales, and New Zealand. Data on Taiwanese MHPs' views of ITO regime were collected from the National Psychiatric Disease Mandatory Assessment and Community Care Review Committee (N = 176). A national survey instrument was designed to assess the level of support for ITOs among senior clinicians and to determine their views on the importance of various factors in decision-making, the mechanisms through which coercion may work, impediments to its use, and its perceived impact on patients and therapeutic relationships. A descriptive analysis was carried out with data presented as appropriate for the distribution and a t-test was used to detect any differences by respondents. Risk reduction was ranked the most important factor in use of ITOs and reasons for discharging an order. Female respondents had higher approval ratings, with 85 % of agreeing that ITOs were of benefit to the therapeutic relationship, assured long-term stability, and increased medication compliance. The results suggest that clinicians decide the use of ITOs largely based on the risk management, both in terms of starting and ending an order. However, the use of ITOs vary which reflected in the practice. Given this variation in the use of enabling legislation, multidisciplinary input in decision-making is an essential safety mechanism.
authors.affiliation: Department of Psychiatry, Chung Shan Medical University Hospital, No.110, Sec 1, Jianguo N. Rd., Taichung City, 40201, Taiwan.|Department of Psychiatry, School of Medicine, Chung Shan Medical University, No.110, Sec 1, Jianguo N. Rd., Taichung City, 40201, Taiwan.
authors.forename: Ming-Hong
authors.initials: MH
authors.lastname: Hsieh
authors.affiliation: Department of Social Work, National Taiwan University, No. 1, Sec. 4, Roosevelt Road, Taipei, Taiwan. hchingwu@ntu.edu.tw.
authors.forename: Hui-Ching
authors.initials: HC
authors.lastname: Wu
authors.affiliation: Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan.|Graduate Institute of Health Care, Meiho University, Neipu, Taiwan.
authors.forename: Frank Huang-Chih
authors.initials: FH
authors.lastname: Chou
authors.affiliation: Oxford Health NHS Foundation Trust, Oxford, UK.|Oxford University, Oxford, UK.|Thames Valley and South Midlands Clinical Research Network, Oxford, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Molodynski
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel / Q000208:ethnology*; D003431:Cross-Cultural Comparison; D004739:England / Q000208:ethnology; D005260:Female; D006801:Humans; D000076083:Involuntary Treatment, Psychiatric; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged; D009520:New Zealand / Q000208:ethnology; D017751:Safety Management; D013624:Taiwan / Q000208:ethnology; D014852:Wales / Q000208:ethnology
keywords: Attitude; Cultural-cultural; Involuntary treatment; Mental healthcare professional; Severe mental illness