Abuse, Care Quality, and Patient Experience of Care in Psychiatric Facilities

This page will host a collection of policy work and research on care quality, coercion, abuse, and patient experience of care in psychiatric facilities. The institutional abuse includes staff-against-patient abuse and neglect and restraint and seclusion, and any studies on reduction of such. These articles may contain pathologizing language.

We will make note of whether the full text is available for free, or if payment is required for people without academic access or journal membership.

This page is under construction, last updated May 2017.

1989

1994

  • Patient allegations of sexual abuse against psychiatric hospital staff. Gen Hosp Psychiatry. 1994 Sep;16(5):335-9. Berland DI, Guskin K.
    • (Abstract only; payment required for full PDF for users without academic access)
    • “We conclude that patient allegations of staff sexual abuse… are not isolated, rare events.” Note: Talks a lot about the impact on the accused workers.

1998

  • A restraint on restraints: the need to reconsider the use of restrictive interventions. by Wanda K. Mohr, M.M. Mahon, and M.J. Noone at Psychiatric Nursing, Volume 12, Issue 2, April 1998.
    • (Abstract only)
    • “Preliminary data are presented from an ongoing study that is investigating the experiences and memories of formerly hospitalized children. Three types of traumatic experiences are described: vicarious trauma, alienation from staff, and direct trauma. Many of the traumatic events endured by child patients are the result of an inappropriate use by staff of power and force.”

2001

  • A plea for respect: involuntarily hospitalized psychiatric patients’ narratives about being subjected to coercion by B. Olofsson and L. Jacobsson in J Psychiatr Ment Health Nurs. 2001 Aug;8(4):357-66.
    • (Abstract only)
    • “A qualitative content analysis identified recurring themes. The core theme “Not being respected as a human being” included most of their narrated experiences, described in the themes Not being involved in one’s own care, Receiving care perceived as meaningless and not good, and Being an inferior kind of human being…. The core theme “Being respected as a human being” included a minor part of the narrated experiences and how the participants wanted things to be, described in the themes Being involved in one’s own care, Receiving good care, and Being a human being like other people.”

2002

2005

  • Coercion, Involuntary Treatment and Quality of Mental Health Care: Is There Any Link?, by Hans Joachim Salize; Harald Dressing, Curr Opin Psychiatry. 2005; 18(5): 576-584.
    • (Full text available online at Medscape)
    • “Nevertheless, involuntary inpatient commitments may also have long-lasting consequences, as they seem to be significantly associated with a higher rate of readmission, as was found in a retrospective analysis of a large US patient file database.”

2008

2011

  • Perceived coercion and the therapeutic relationship: a neglected association? by K.A. Sheehan, T. Burns at Psychiatric Services, Volume 62, Issue 5, May 2005.
    • (Abstract only)
    • “RESULTS: High levels of coercion were experienced by 48% of voluntarily and 89% of involuntarily admitted patients. A high perceived coercion score was significantly associated with involuntary admission and a poor rating of the therapeutic relationship. The therapeutic relationship confounded legal status as a predictor of perceived coercion.”
  • Black Boxing Restraints: The Need for Full Disclosure and Consent, by by Wanda K. Mohr and Michael A. Nunno at Journal of Child and Family Studies, Volume 20, Issue 1, page 8-47, February 2011.
    • (Full PDF available for download)
    • “We… contend that if restraints are used they must pose less risk than the behavior they are trying to alleviate. We also opine that if restraints are misused by mental health or child welfare treatment settings, then their misuse may be considered a subject of a patient maltreatment, abuse, criminal or civil action. A central thesis of the article is that informed consent must be seen as an integral and dynamic process of treatment.”

2015

2016

  • Who is Subjected to Coercive Measures as a Psychiatric Inpatient? A Multi-Level Analysis by E. Flammer, T. Steinert, F. Eisele, J. Bergk, and C. Uhlmann.
    • (Full text available online and as PDF)
    • “Patients with aggressive behaviour in the 24 hours prior to admission had a three times higher risk of coercive measures compared to non-aggressive patients. Severity of illness increased the risk of coercion markedly. With each level of severity, the risk of coercion was doubled. Voluntariness of stay appeared to be the best protective factor against coercive measures. If a patient stayed voluntarily, this reduced the risk of coercion by more than two thirds.”
  • Quality of interactions influences everyday life in psychiatric inpatient care—patients’ perspectives by Jenny Molin (PhD student) , Ulla H. Graneheim (Associate Professor) & Britt-Marie Lindgren (Senior Lecturer) at International Journal of Qualitative Studies on Health and Well-being, Volume 11, 2016 – Issue 1
    • (Full text available online, as well as PDF for download)
    • “Quality interactions, that is, closeness to staff in ordinary relationships and spending quality time through simple activities would improve patients’ experiences of everyday life in psychiatric inpatient care and thereby contribute to their recovery…  It is also crucial for staff to have ongoing discussions about their interactions with patients.”

2017