Attitudes and opinions on coercion among professionals

In this article the authors – Olaf Gjerløw Aasland, Tonje Lossius, Reidun Førde and Reidar Pedersen – analyses authoritarian and dialogical approaches in attitudes and opinions on coercion among professionals in mental health and addiction care in Norway.

Aasland OG, Husum TL, Førde R, Pedersen R. Between authoritarian and dialogical approaches: attitudes and opinions on coercion among professionals in mental health and addiction care in Norway. International Journal of Law and Psychiatry 2018; 57: 106-12.

Published online 2 March 2018. E-pub ahead of print.

Abstract in PubMed:
More knowledge is needed on how to reduce the prevalence of formal and informal coercion in Norwegian mental health care. To explore possible reasons for the widespread differences in coercive practice in psychiatry and drug addiction treatment in Norway, and the poor compliance to change initiatives, we performed a nationwide survey. Six vignettes from concrete and realistic clinical situations where coercive measures were among the alternative courses of action, and where the difference between authoritarian (paternalistic) and dialogical (user participation) practices was explicitly delineated, were presented in an electronic questionnaire distributed to five groups of professionals: psychiatrists, psychologists, nurses, other professionals and auxiliary treatment staff. Non-coercive dialogical resolutions were more likely than coercive authoritative. However, there is a clear professional hierarchy with regard to authoritarian approaches, with the psychiatrists on top, followed by nurses and other professionals, and with psychologists as the least authoritarian. The majority of the respondents sometimes prefer actions that are illegal, which suggests that individual opinions about coercion often overrule legislation. The variation between and within professional groups in attitudes and opinions on coercion is extensive, and may account for some of the hitherto meagre results of two ministerial action plans for coercion reduction.

The article published in International Journal of Law and Psychiatry had 50 days' free access (until 21 April 2018) by clicking on this link: https://authors.elsevier.com/a/1WenTaR~~IVvk. You can also find the article in full text version on Elsevier.com via this link: https://www.sciencedirect.com/science/article/pii/S0160252717301358

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Read more about the study (in Norwegian):
- "Psykiatere velger oftere tvang enn psykologer", Mari Rian Hanger, Dagens Medisin 9/2018, s. 34-35  (3.5.2018)