Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco.
Psychiatr Serv. 2021 Mar 1;72(3):302-310. doi: 10.1176/appi.ps.202000427. Epub 2021 Jan 12.
Psychiatry has a contentious history of coercion in the care of patients with mental illness, and legal frameworks often govern use of coercive interventions, such as involuntary hospitalization, physical restraints, and medication over objection. Research also suggests that informal coercion, including subtle inducements, leverage, or threats, is prevalent and influential in psychiatric settings. Digital technologies bring promise for expanding access to psychiatric care and improving delivery of these services; however, use and misuse of digital technologies, such as electronic medical record flags, surveillance cameras, videoconferencing, and risk assessment tools, could lead to unexpected coercion of patients with mental illness. Using several composite case examples, the author proposes that the integration of digital technologies into psychiatric care can influence patients' experiences of coercion and provides recommendations for studying and addressing these effects.
精神病学在对精神病患者的护理中有着颇具争议的强制历史，法律框架通常对强制干预的使用进行规范，例如非自愿住院、身体约束和不顾反对使用药物。研究还表明，非正式强制，包括微妙的诱导、利用或威胁，在精神科环境中普遍存在且具有影响力。数字技术有望扩大精神科护理的可及性并改善这些服务的提供；然而，数字技术的使用和滥用，如电子病历标记、监控摄像头、视频会议和风险评估工具，可能导致对精神病患者的意外强制。作者使用几个综合案例示例，提出将数字技术融入精神科护理会影响患者的强制体验，并为研究和解决这些影响提供建议。
