Informal coercion to enhance treatment adherence among psychiatric patients

OBJECTIVE: We aimed at assessing prevalence and risk factors of interventions including informal coercion to enhance treatment adherence (leverage) in Switzerland. Additionally, we studied attitudes of psychiatric patients towards these methods. METHODS: A sample of 187 psychiatric patients with outpatient treatment underwent a semi structured interview. RESULTS: 29% had experience with one or more methods to enhance treatment adherence. The most prevalent intervention was to link housing to patients' readiness to consent with psychiatric treatment. Announcing a less invasive criminal sanction to a psychiatric patient who was arrested or convicted due to a criminal offence was the method to enhance treatment adherence study subjects' endorsed the most. The use of child custody as a tool to enhance treatment acceptance was rejected by the majority of the sample. CONCLUSIONS: Interventions including informal coercion are prevalent in the treatment of psychiatric patients. In order to assess if and under what circumstances implementation of these interventions is justified we need to consider the subjective perspective of the affected individuals.