Optimistic recovery expectations are associated with critical attitudes toward coercion among mental health professionals [2019]

The use of coercion poses a key concern in terms of patients’ rights. To reduce coercive interventions, a change in the attitudes of mental health professionals toward coercion has been proposed. This study examined whether individual and workplace characteristics are associated with attitudes toward coercion. A sample of 110 staff members of a large psychiatric hospital working on open or closed wards completed a survey that included measures of issues such as attitudes toward coercion (Staff Attitude to Coercion Scale [SACS]), recovery orientation (RAQ-7), and individual and workplace characteristics. We also assessed ward characteristics from routine medical data. Associations were determined by correlations and regression analysis. Overall, 73.6% of the professionals were critical of the use of coercion, whereas 5.5% had positive attitudes toward coercive measures. Participants with more optimistic recovery expectations, other than nurses, and those working on open wards held more critical attitudes toward coercion (p < 0.05). Wards characterized by less coercive measures, lower bed occupancy, fewer involuntary admissions and substance-use disorders were associated with more critical attitudes (p < 0.05). We conclude that training of mental health professionals—especially nurses and those who work on closed wards—in recovery orientation may help promote critical attitudes toward coercion and may reduce coercive measures.

Sonja Mötteli, Florian Hotzy, Fabian Lamster, Rahel Horisberger, Anastasia Theodoridou, Stefan Vetter, Erich Seifritz & Matthias Jäger
International Journal of Mental Health, Volume 49, 2020 – Issue 2