Mental health professionals' perceptions and attitudes towards seclusion: The ambivalent relationship between safety and therapeutic considerations.

Background: Frequency of seclusion in acute psychiatric units varies greatly worldwide. In Switzerland, its use is authorised under strict conditions. However, this coercive measure is not implemented in every psychiatric hospital in the country.

Pathways to experienced coercion during psychiatric admission: a network analysis.

Background: In mental health care, experienced coercion, also known as perceived coercion, is defined as the patient's subjective experience of being submitted to coercion. Besides formal coercion, many other factors have been identified as potentially affecting the experience of being coerced. This study aimed to explore the interplay between these factors and to provide new insights into how they lead to experienced coercion.

Measurement of perceived pressures in psychiatry: paper-and-pencil and computerized adaptive version of the P-PSY35 scale.

Purpose: Formal coercion in psychiatry is widely studied yet much less is known about pressures patients may experience, partly because of the very few measures available. The goal of this study was to validate the P-PSY35 (Pressures in Psychiatry Scale) and provide a paper-and-pencil and a computerised adaptive test (CAT) to measure pressures experienced by patients in psychiatry.

Methods: The P-PSY35 items were developed with users.

How do decision making and fairness mediate the relationship between involuntary hospitalisation and perceived coercion among psychiatric inpatients?

Background: Coercion perceived by psychiatric inpatients is not exclusively determined by formal measures such as involuntary admissions, seclusion or restraint, but is also associated with patients' characteristics and professionals' attitude.

Aims: This study examined how inpatients' involvement in the decision making process, the respect of their decision making preference, and their feeling of having been treated fairly mediate the relationship between involuntary hospitalisation and perceived coercion both at admission and during hospital stay.

Methods: Mediation analysis were performed in order to study the relationship between involuntary hospitalisation and perceived coercion among 230 patients, voluntarily and involuntarily admitted in six psychiatric hospitals.

Association between perceived coercion and perceived level of information in involuntarily admitted patients: Results from a multicenter observational study in Switzerland.

Background: Involuntary admissions (IA) to psychiatric hospitals are controversial because they interfere with people's autonomy. In some situations, however, they appear to be unavoidable. Interestingly, not all patients perceive the same degree of coercion during IA.

[Cantonal Differences in The Implementation of Involuntary Admission in Switzerland].

Objective: To examine sociodemographic and clinical characteristics of persons hospitalized in five psychiatric hospitals from regions with different structural characteristics compared with persons hospitalized voluntarily.

Methods: Descriptive analyses of routine data on approximately 57000 cases of 33000 patients treated for a primary ICD-10 psychiatric diagnosis at one of the participating hospitals from 2016 to 2019.

Results: Admission rates, length of stay, rates of further coercive measures, sociodemographic and clinical characteristics of the affected persons differ between the different regions.

Exploring Patients' Feeling of Being Coerced During Psychiatric Hospital Admission: A Qualitative Study.

Various coercive measures can be used to legally compel a person suffering from psychiatric disorder to undergo treatment. However, evidence suggests that patients' feeling of being coerced is not determined solely by their being submitted to formal coercion. This study aimed to explore voluntary and involuntary patients' experience of coercion during psychiatric hospitalisation and to identify which factors, from their perspective, most affected it.

[A patient-researcher in psychiatry: the role of lived experience in the production of knowledge].

Clinicians do not have the same awareness of pain as patients. In some circumstances, the patients' pain is too distant from the clinicians' experience, making difficult for them to understand what the patient is talking about. To overcome this lack of understanding, a growing movement is emerging in psychiatry which value experiential expertise through the development of partnership with expert patients.

Involuntary admissions to the emergency department: a retrospective observational study.

Aims: The main objective of this study was to describe patients who were involuntarily admitted to the emergency department of Lausanne University Hospital on involuntary admission in 2018 in terms of age, gender, emergency department length of stay, the motive for involuntary admission, use of psychoactive substances, diagnosis, and destination at emergency department discharge, with or without discontinuation of involuntary admission.

Methods: This retrospective, observational, and monocentric study included patients 18 years and older admitted to the emergency department of Lausanne University Hospital on involuntary admission from January 1, 2018, to December 31, 2018. Patients were identified by the Cantonal Medical Office of Vaud.

Feeling coerced during voluntary and involuntary psychiatric hospitalisation: A review and meta-aggregation of qualitative studies.

Objective: This review aimed to provide an aggregative synthesis of the qualitative evidence on patients' experienced coercion during voluntary and involuntary psychiatric hospitalisation.

Design: A qualitative review.

Data Sources: The search was conducted, in five bibliographic databases: Embase.

Satisfaction and Perceived Coercion in Voluntary Hospitalisations: Impact of Past Coercive Experiences.

Coercion in psychiatry is associated with several detrimental effects, including in the long term. The effect of past experience of coercion on the perception of subsequent hospitalisations remains less studied. The present study aimed to assess the impact of past experience of coercion on the perception of coercion and satisfaction with subsequent voluntary hospitalisations.

Patterns of Service Use in Intensive Case Management: A Six Year Longitudinal Study.

An Intensive Case Management (ICM) intervention has been developed in Lausanne, Switzerland. It aims to promote access to care for people with severe mental disorders who have difficulties to engage with mental health services because of the severity of their disorders and/or their marginality. ICM embrace components of assertive community treatment and critical time intervention.

Perceived fairness as main determinant of patients' satisfaction with care during psychiatric hospitalisation: An observational study.

Introduction: Patient satisfaction with care is widely recognized as one of the most important indicator of quality in mental health care. It can impact several treatment outcomes, such as treatment adherence and engagement with services. At the same time, as an outcome in itself, satisfaction with care is also affected by several factors, first and foremost by being coerced.

Predicting involuntary hospitalization in psychiatry: A machine learning investigation.

Background: Coercion in psychiatry is a controversial issue. Identifying its predictors and their interaction using traditional statistical methods is difficult, given the large number of variables involved. The purpose of this study was to use machine-learning (ML) models to identify socio-demographic, clinical and procedural characteristics that predict the use of compulsory admission on a large sample of psychiatric patients.

Measuring the paradox of self-stigma: psychometric properties of a brief scale.

Background: Exposure to public stigma can lead to stereotype endorsement and resignation, which are constructs related to self-stigma. This latter phenomenon has well-documented deleterious consequences for people living with mental illness. Paradoxically, it can also lead to the empowering reactions of righteous anger and coming out proud.

Mental health professionals' feelings and attitudes towards coercion.

Background: Despite absence of clear evidence to assert that the use of coercion in psychiatry is practically and clinically helpful or effective, coercive measures are widely used. Current practices seem to be based on institutional cultures and decision-makers' attitudes towards coercion rather than led by recommendations issued from the scientific literature. Therefore, the main goal of our study was to describe mental health professionals' feelings and attitudes towards coercion and the professionals' characteristics associated with them.

Propensity to decide on involuntary hospitalisation in primary medical care: Dispositional or situational determinants?

Background: The incidence of involuntary hospitalisations varies widely among and within countries. One factor that could account for these variations is the local profile of medical doctors deciding on involuntary admissions. The first goal of this study was to test whether to decide on an involuntary hospitalisation was an individual or a situational disposition.

Feeling coerced during psychiatric hospitalization: Impact of perceived status of admission and perceived usefulness of hospitalization.

Introduction: Perceived coercion is not exclusively related to the patient's legal status at admission. Patients are not always aware of their correct status and voluntary patients often report having felt coerced. Moreover, involuntary patients commonly report that their hospitalization was justified.

Community treatment orders in Western Switzerland: A retrospective epidemiological study.

Purpose: Community treatment orders (CTOs) are legal procedures that authorise compulsory community mental health care to people affected by severe mental disorders. Nowadays, CTOs are regulated in 75 countries, with important variations in terms of legal criteria and practices. In Switzerland CTOs were introduced on the 1 January 2013, following the amendment of the Swiss Civil Code.

[Alternatives to psychiatric hospitalisation].

In psychiatry, alternatives to hospitalisation have been developed further to deinstitutionalisation. With the decrease in the number of psychiatric beds and the emergence of new representations regarding the possibility of recovery for people with mental disorder, hospitalisations have been limited to crisis periods. Sheltered housing has been created for vulnerable people.

Psychometric properties of the French-language version of the Coercion Experience Scale (CES).

Background: The Coercion Experience Scale (CES) was designed to measure the psychological impact of psychiatric coercive interventions. The French-language CES was adapted using a translation/back-translation procedure. It consists originally of 31 items and 6 subscores.

Identifying patterns in psychiatric hospital stays with statistical methods: towards a typology of post-deinstitutionalization hospitalization trajectories.

Purpose: Over the past 50 years, deinstitutionalization changed the face of psychiatry. However, outpatient treatment in the community does not always fit the needs of those who left institutions and sometimes leads to frequent re-hospitalizations, a mechanism known as the "revolving door" phenomenon. The study aim was to identify different typologies of hospitalization trajectories.

Factors associated with involuntary hospitalisation for psychiatric patients in Switzerland: a retrospective study.

Background: Despite the scarce evidence for patients' benefits of coercion and its well-documented negative effects, the use of compulsion is still very common around Europe, with important variations among different countries. These variations have been partially explained by the different legal frameworks, but also by several individual-related, system-related and area-related characteristics, identified as predictors of the use of coercive measures. This study aimed to compare the socio-demographic and clinical profile as well as the referral and hospitalisation process of people voluntarily and involuntarily hospitalized in order to identify which factors could be associated with the use of coercion.

Perceived coercion in psychiatric hospital admission: validation of the French-language version of the MacArthur Admission Experience Survey.

Background: The MacArthur Admission Experience Survey (AES) is a widely used tool to evaluate the level of perceived coercion experienced at psychiatric hospital admission. The French-language AES was prepared using a translation/back-translation procedure. It consists of 16 items and 3 subscores (perceived coercion, negative pressures and voice).