Perceived coercion in mental hospital admission. Pressures and process

UMMS Affiliation

Department of Psychiatry

Publication Date


Document Type



Adult; *Coercion; *Diagnostic Tests, Routine; Female; Humans; Interviews as Topic; Male; Mental Disorders; *Perception; Regression Analysis


Health Services Research | Mental and Social Health | Psychiatry | Psychiatry and Psychology


BACKGROUND: Patients' perceptions of coercion in admission may affect their attitude toward subsequent treatment, including their inclination to adhere to treatment plans. This study looks at the determinants of patients' perceptions of coercion.

METHODS: A sample of 157 patients admitted to a rural Virginia state hospital and a Pennsylvania community hospital were interviewed within 48 hours of admission about their experience of coming to the hospital. All subjects were 17 years or older. Diagnoses were diverse, and 42% were involuntarily committed. The interview gathered an open-ended description of the admission experience followed by a structured interview that included several measures.

RESULTS: Perceptions of being respectfully included in a fair decision-making process ("procedural justice") and legal status were most closely associated with perceived coercion, and a significant relationship was found with perceived negative pressures, ie, force and threats. However, only procedural justice was related to the perception of coercion at both sites and with both voluntary and involuntary patients.

CONCLUSIONS: Patients' feelings of being coerced concerning admission appears to be closely related to their sense of procedural justice. It may be that clinicians can minimize the experience of coercion even among those legally committed by attending more closely to procedural justice issues.


Arch Gen Psychiatry. 1995 Dec;52(12):1034-9.

Journal/Book/Conference Title

Archives of general psychiatry

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Link to Article in PubMed

PubMed ID