Chemical restraint: A qualitative synthesis review of adult service user and staff experiences in mental health settings

Nurs Health Sci. 2021 Jun;23(2):325-336. doi: 10.1111/nhs.12822. Epub 2021 Mar 11.


With an imperative to reduce or eliminate the use of coercive practices in mental health care it is important to understand the experience of service users and staff. This review aimed to synthesize qualitative studies, published between 1996 and 2020, reporting on mental health service users' and staff's experiences of chemical restraint. The databases PsycINFO, CINAHL, MEDLINE, Embase, Emcare, Web of Science, and Scopus were searched. Three analytic themes were identified from 17 included articles, synthesizing the experiences of service users and staff. These were "Unjustified versusjustified," "Violence versus necessity," and "Reflecting back: Positives and negatives." Service users viewed chemical restraint as an unjustified response to "behaviors of concern" and experienced it as a violent act with negative outcomes, although some saw it as necessary in retrospect and preferred it to other forms of coercion. Staff generally viewed it as a justified response to "behaviors of concern" and experienced it as appropriate within the constraints of staff numbers and limited alternatives. These findings identify nuances not apparent in the literature, which has generally conflated all forms of coercive practices.

Keywords: chemical restraint; coercive practices; forced medication; involuntary medication; psychiatric; qualitative synthesis.

Publication types

  • Review

MeSH terms

  • Behavior Control / methods
  • Coercion*
  • Humans
  • Mental Health
  • Mental Health Services / statistics & numerical data*
  • Restraint, Physical
  • Tranquilizing Agents / therapeutic use*
  • Violence / prevention & control*


  • Tranquilizing Agents