Introduction: Even if coercive measures are widely applied in psychiatry and have numerous well-known
drawbacks, there is limited known on the agreement among mental healthcare professionals’ opinions
on their use. In a questionnaire study using standardized scenarios, we investigated variation in staff
opinions on coercion.

Methods: In a web-based survey distributed to staff at three psychiatry hospitals, respondents were
asked to consider if and what coercion to use by introducing two hypothetical scenarios involving
involuntary psychiatric admission and in-hospital coercion.

Results: One hundred thirty-two out of 601 invited staff members responded to the survey (Response
Rate = 22%). There was large variation in participating staff members’ opinions on how to best manage
critical situations and what coercive measures were warranted. In the first scenario, 57% of respondents
(n = 76) believed that the patient should be involuntarily admitted to hospital while the remaining
respondents believed that the situation should be managed otherwise. Regarding the second scenario,
62% of respondents responded that some in-hospital coercion should be used. The majority of
respondents believed that colleagues would behave similarly (60%) or with a tendency towards more
coercion use (34%). Male gender, being nursing staff and having less coercion experience predicted
being less inclined to choose involuntary hospital admission.

Conclusion: There is a high degree of variation in coercion use. This study suggests that this variation
persists despite staff members being confronted with the same standardized situations. There is a need
for evidence-based further guidance to minimize coercion in critical mental healthcare situations.
Original languageEnglish
JournalNordic Journal of Psychiatry
Publication statusE-pub ahead of print - 2024


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