The therapeutic relationship in involuntary inpatient care

Background

Involuntary treatment in a psychiatric hospital is often a long, complicated process likely to elicit strong feelings in patients experiencing it. Relationships with hospital staff members might have an impact on patients' experiences and emotions. Qualitative research in this area would offer a better understanding of patients' views on the role of the ward staff and their involvement in their care.

Methods

The present study is part of a large-scale investigation on outcomes of involuntary admission. 60 in-depth semi-structured interviews were conducted with patients who had been involuntarily admitted in 4 sites in England. The sampling and analysis methodology draws on grounded theory. The sample includes participants admitted under different sections of the Mental Health Act. Their views of the ward staff and their evaluation of professionals-patients relationships were explored. The impact of both positive and negative attitudes and experiences was also discussed. Interviews were tape-recorded and transcribed verbatim. Data was coded using MAXqda software for qualitative analysis.

Results

Results indicate that patients report both positive and negative experiences with staff. Positive experiences are perceived as supportive and helpful, whereas negative ones leave patients feeling disrespected, not cared, devalued and losing control over their lives.