Efkemann Simone Agnes, Scholten Matthé, Bottlender Ronald, Juckel Georg, Gather Jakov
Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL University Hospital Bochum, Ruhr University, Bochum, Germany.
Institute for Medical Ethics and History of Medicine, Ruhr University, Bochum, Germany.
Acta Psychiatr Scand. 2022 Aug;146(2):151-164. doi: 10.1111/acps.13429. Epub 2022 Apr 4.
Research on coercion in mental healthcare has recently shifted to the investigation of subjective aspects, both on the side of the people with mental disorders affected and the staff members involved. In this context, the role of personality traits and attitudes of staff members in decision-making around coercion is increasingly being assessed. This study aimed to examine the role of staff attitudes towards coercion and staff members' personality traits in decision-making around coercion in an experimental setting.
We assessed the attitudes towards coercion and (general) personality traits of mental health professionals in psychiatric hospitals with a quantitative survey. Furthermore, we developed case vignettes representing cases in a 'grey zone' and included them in the survey to assess staff members' decisions about coercion in specific situations.
A general approving attitude towards coercion significantly influenced decisions around coercion in individual cases-resulting in a more likely approval of applying coercion in the cases described in the vignettes. Personality traits did not seem to be relevant in this regard.
Strategies to reduce coercion in mental healthcare institutions should focus more on the role of staff attitudes and encourage staff members to reflect on them critically.
精神卫生保健领域中关于强制治疗的研究最近已转向对主观方面的调查，涉及受影响的精神障碍患者群体以及相关工作人员。在此背景下，工作人员的人格特质和态度在围绕强制治疗的决策中的作用正日益受到评估。本研究旨在通过实验环境考察工作人员对强制治疗的态度以及人格特质在围绕强制治疗的决策中的作用。
我们通过定量调查评估了精神病医院精神卫生专业人员对强制治疗的态度和（一般）人格特质。此外，我们编写了代表“灰色地带”案例的病例 vignettes，并将其纳入调查，以评估工作人员在特定情况下对强制治疗的决策。
对强制治疗的总体认可态度显著影响了个别案例中围绕强制治疗的决策——导致在 vignettes 中描述的案例中更有可能批准实施强制治疗。在这方面，人格特质似乎并无关联。
精神卫生保健机构中减少强制治疗的策略应更多地关注工作人员态度的作用，并鼓励工作人员对此进行批判性反思。
