Experience of coercion and treatment pressures amongst mental health service users

The existing body of literature indicates that psychiatric service-users commonly
experience treatment pressures. In the research to date there has been a bias
towards investigating (often compulsory) hospital admission and treatment at the
expense of finding out about the wide range of experiences that service-users
potentially perceive as treatment pressures. Similarly little research has explored
the effects of these experiences over time, the processes that mediate them, or
how they are managed. This research sought to explore these neglected issues,
which is paramount for the development of a more ethical psychiatric service
provision.
Ten mental health service-users were interviewed with regards to their
experiences of treatment pressure; the effects of these experiences; and the
processes involved in their management of them. A thematic analysis of these
interviews was constructed. The overarching theme, ‘experiencing and managing
treatment pressure’, was comprised of four themes: ‘A personal experience’, ‘A
relational experience’, ‘A culturally bound experience’, and ‘Taking control: “it’s
fight, flight or comply”’.
The analysis indicated that the experiences of treatment pressure had wide
reaching and enduring effects for participants in terms of: their understanding of
the world; their self-identity; their relationships with others; and their social
category status. In order to manage these experiences and incorporate them into
narratives about themselves participants appeared to ‘take control’ of their
experiences in different and multiple ways. Managing their experiences in this
way seemed to ameliorate the often highly distressing and disturbing effects of
treatment pressures.
The thesis ends with a consideration of both clinical and research implications.