Personal recovery and involuntary mental health admissions: the importance of control, relationships and hope

Purpose: Involuntary mental health admissions remain a highly contested area in law, policy and practice. There are growing concerns about the effectiveness and potential harms of using coercion to enable treatment. These concerns are heightened by the worldwide shift to recovery oriented care, which emphasizes the importance for mental health consumers experiencing self- sufficiency, control and having input into their own treatment. Involuntary treatment challenges these very principles. Methods: For this study we adapted Noblit and Hare Meta Ethnography methods and synthesized the themes of seven qualitative studies which focused on the experiences of involuntary mental health admission. Results: Seven overarching dimensions were identified as either hindering or facilitating recovery, namely: 1) having input into own treatment; 2) shared humanity; 3) power imbalance/ balance; 4) freedom and control; 5) ability/inability to incorporate the episode/experience; 6) treatment factors; and 7) importance of relationships. Conclusions: The findings of this study indicate that the recovery framework, in particular the concepts of hope, relationships and control are very relevant in the context of involuntary settings.