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

摘要

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.