A cross-sectional study of experienced coercion in adolescent mental health inpatients.
BACKGROUND
Involuntary care and coercive measures are frequently present in mental healthcare for adolescents. The purpose of this study was to examine to what extent adolescents perceive or experience coercion during inpatient mental health care, and to examine predictors of experienced coercion.


METHODS
A cross-sectional sample of 96 adolescent inpatients from 10 Norwegian acute and combined (acute and sub-acute) psychiatric wards reported their experienced coercion on Coercion Ladder and the Experienced Coercion Scale in questionnaires. Staff reported use of formal coercion, diagnoses, and psychosocial functioning. We used two tailed t-tests and mixed effects models to analyze the impact from demographics, alliance with parents, use of formal coercion, diagnostic condition, and global psychosocial functioning.


RESULTS
High experienced coercion was reported by a third of all patients. In a mixed effects model, being under formal coercion (involuntary admission and / or coercive measures); a worse relationship between patient and parent; and lower psychosocial functioning, significantly predicted higher experienced coercion. Twenty-eight percent of the total sample of patients reported a lack of confidence and trust both in parents and staff.


CONCLUSIONS
Roughly one third of patients in the sample reported high experienced coercion. Being under formal coercion was the strongest predictor. The average scores of experienced coercion in subgroups are comparable with adult scores in similar care situations. There was one exception: Adolescents with psychosis reported low experienced coercion and almost all of them were under voluntary care.
['Nyttingnes|Olav|O|0000-0003-0991-7176', 'Ruud|Torleif|T|', 'Norvoll|Reidun|R|', 'Rugkåsa|Jorun|J|', 'Hanssen-Bauer|Ketil|K|']
D000293:Adolescent D000328:Adult D003068:Coercion D003430:Cross-Sectional Studies D005260:Female D006801:Humans D007297:Inpatients D007902:Length of Stay D008297:Male D001523:Mental Disorders D008603:Mental Health D009664:Norway D010465:Perception D011567:Psychiatric Department, Hospital D011618:Psychotic Disorders D011795:Surveys and Questionnaires
Cross-sectional studies Involuntary admission Adolescent psychiatry Perceived coercion