Physical coercion, perceived pressures and procedural justice in the involuntary admission and future engagement with mental health services

Abstract

Objectives: We sought to determine the level of procedural justice experienced by individuals at the time of involuntary admission and whether this influenced future engagement with the mental health services.

Methods: Over a 15-month period, individuals admitted involuntarily were interviewed prior to discharge and at one-year follow-up.

Results: Eighty-one people participated in the study and 81% were interviewed at one-year follow-up. At the time of involuntary admission, over half of individuals experienced at least one form of physical coercion and it was found that the level of procedural justice experienced was unrelated to the use of physical coercive measures. A total of 20% of participants intended not to voluntarily engage with the mental health services upon discharge and they were more likely to have experienced lower levels of procedural justice at the time of admission. At one year following discharge, 65% of participants were adherent with outpatient appointments and 18% had been readmitted involuntarily. Insight was associated with future engagement with the mental health services; however, the level of procedural justice experienced at admission did not influence engagement.

Conclusions: This study demonstrates that the use of physical coercive measures is a separate entity from procedural justice and perceived pressures.