Different forms of informal coercion in psychiatry: a qualitative study

BMC Res Notes. 2019 Dec 2;12(1):787. doi: 10.1186/s13104-019-4823-x.


Objectives: The objective of the study was to investigate how mental health professionals describe and reflect upon different forms of informal coercion.

Results: In a deductive qualitative content analysis of focus group interviews, several examples of persuasion, interpersonal leverage, inducements, and threats were found. Persuasion was sometimes described as being more like a negotiation. Some participants worried about that the use of interpersonal leverage and inducements risked to pass into blackmail in some situations. In a following inductive analysis, three more categories of informal coercion was found: cheating, using a disciplinary style and referring to rules and routines. Participants also described situations of coercion from other stakeholders: relatives and other authorities than psychiatry. The results indicate that informal coercion includes forms that are not obviously arranged in a hierarchy, and that its use is complex with a variety of pathways between different forms before treatment is accepted by the patient or compulsion is imposed.

Keywords: Coercion; Ethics; Informal coercion; Leverage; Psychiatry; Qualitative research.

MeSH terms

  • Coercion*
  • Focus Groups
  • Humans
  • Mental Health Services
  • Psychiatry*
  • Qualitative Research*