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David Crompton - One of the best experts on this subject based on the ideXlab platform.
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therapeutic relationships and Involuntary Treatment orders service users interactions with health care professionals on the ward
International Journal of Mental Health Nursing, 2015Co-Authors: Marianne Wyder, Robert Bland, Andrew Blythe, Beth Jane Matarasso, David CromptonAbstract:There is increasing evidence that an Involuntary hospital admission and Treatment can undermine the therapeutic relationship. While good relationships with staff are important factors influencing long-term recovery, there is little information on how people experience their relationships with staff while under an Involuntary Treatment order (ITO). Twenty-five Involuntary inpatients were interviewed about their experiences of an ITO. The interviews were analysed by a general inductive approach. Participants described the following themes: (i) the ITO admission was a daunting and frightening experience; (ii) staff behaviours and attitudes shaped their experiences in hospital; (iii) importance of staff listening to their concerns; (iv) importance of having a space to make sense of their experiences; (v) importance of staff ability to look beyond their illness and diagnosis; and (vi) importance of staff working in partnership. These findings highlight that when using recovery principles, such as an empathic engagement with the patients' lived experience, forging partnerships with patients in Treatment decision-making to enhance agency, an Involuntary Treatment order does not have to limit the ability to establish positive relationships.
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The experiences of the legal processes of Involuntary Treatment orders: Tension between the legal and medical frameworks
International Journal of Law and Psychiatry, 2015Co-Authors: Marianne Wyder, Robert Bland, Ann Herriot, David CromptonAbstract:3An Involuntary Treatment order (ITO) allows a person to be treated for a mental illness without consent under some circumstances. While the Treatment and assessment of mental illness are essentially clinical decisions, Involuntary mental health admissions are governed by a framework of legal principles, safeguards and procedures. The underlying philosophy of these laws is based on therapeutic jurisprudence. This approach focuses on the importance of the legal process as a social force and suggests that this can either protect or empower people. The legal processes can however adversely impact upon people's states of mind. This study reports on 25 qualitative interviews with Involuntary inpatients of a major teaching hospital. The interviews were analysed thematically using a general inductive approach. The analysis focused on the patients' general experience of being placed under an ITO and their understanding of the ITO process. Generally, those who described the experience of an ITO in more positive terms, also experienced the ITO as a positive right. In addition to providing them with the Treatment needed, they also felt that the ITO gave them protection and guidance. Conversely, those who experienced being placed under an ITO in more negative or mixed ways, described feeling powerless in the process, as they felt that the ITO took away their rights. By and large the ITO process was experienced as arbitrary when patients did not understand the reasons for their admission. In addition, these patients had limited or no information about their Involuntary Treatment order and they did not know what was expected of them to have the ITO revoked. Most importantly, they did not feel that there were any meaningful legal protections in place. These experiences highlight the importance of the legal processes and how these can be used as clinical tools.
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Therapeutic relationships and Involuntary Treatment orders: Service users' interactions with health‐care professionals on the ward
International journal of mental health nursing, 2015Co-Authors: Marianne Wyder, Robert Bland, Andrew Blythe, Beth Jane Matarasso, David CromptonAbstract:There is increasing evidence that an Involuntary hospital admission and Treatment can undermine the therapeutic relationship. While good relationships with staff are important factors influencing long-term recovery, there is little information on how people experience their relationships with staff while under an Involuntary Treatment order (ITO). Twenty-five Involuntary inpatients were interviewed about their experiences of an ITO. The interviews were analysed by a general inductive approach. Participants described the following themes: (i) the ITO admission was a daunting and frightening experience; (ii) staff behaviours and attitudes shaped their experiences in hospital; (iii) importance of staff listening to their concerns; (iv) importance of having a space to make sense of their experiences; (v) importance of staff ability to look beyond their illness and diagnosis; and (vi) importance of staff working in partnership. These findings highlight that when using recovery principles, such as an empathic engagement with the patients' lived experience, forging partnerships with patients in Treatment decision-making to enhance agency, an Involuntary Treatment order does not have to limit the ability to establish positive relationships.
Loa Clausen - One of the best experts on this subject based on the ideXlab platform.
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Perspectives on Involuntary Treatment of Anorexia Nervosa.
Frontiers in psychiatry, 2020Co-Authors: Loa ClausenAbstract:Involuntary Treatment of anorexia nervosa is an option in cases in which the patient’s life or other people’s lives are at risk or, in some countries, to prevent the deterioration of the illness. Involuntary Treatment is often regarded as controversial and has been intensely debated, although typically with few references to documented knowledge. This paper provides a research perspective of the topic by examine data in the field of the Involuntary Treatment of anorexia nervosa to pinpoint present knowledge as well as areas demanding clinical action or research attention. The prevalence of Involuntary Treatment in general as well as specific measures is described and possible early markers of patients at risk of Involuntary Treatment are discussed. Studies including patients’ perspectives of Involuntary Treatment show the complexity of this Treatment, its initiation, and its consequences. To qualify future discussions, improve current practice, and minimize Involuntary Treatment in general as well as on an individual level, at least four areas need attention: (i) the present specific symptoms of anorexia nervosa and their imminent consequences, (ii) illness history, (iii) overall psychiatric symptoms and general functioning, and (iv) contextual sphere of the patient. In particular, the last two require attention from both clinicians and researchers. Furthermore, critical evaluation of the attitudes of both patients and health care professionals towards each other and the Treatment is recommended.
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A Danish register‐based study on Involuntary Treatment in anorexia nervosa
The International journal of eating disorders, 2018Co-Authors: Loa Clausen, Janne Tidselbak Larsen, Cynthia M. Bulik, Liselotte PetersenAbstract:OBJECTIVE Involuntary Treatment is controversial and widely debated, but remains a significant component of Treatment for severe anorexia nervosa. Given how little is known about this topic, we describe the frequency of various Involuntary measures in a national cohort of all patients diagnosed with anorexia nervosa. In a subsample of patients, we explored predictors of the first Involuntary measure recorded. METHOD Descriptive statistics and Cox proportional hazard analyses were conducted using the national registers of Denmark covering the total population. Data from the National Patient Register and the Psychiatric Central Research Register including all psychiatric visits from 1969 onwards were merged with data from the National Register on Coercion covering 1999 onward. Involuntary measures registered between 2000 and 2013 were analyzed. RESULTS A total of 4,727 patients with a diagnosis of anorexia nervosa representing 16,592 admissions were included. Eighteen percent experienced at least one Involuntary measure. A variety of measures were used with tube feeding being the most frequent followed by mechanical restraint, Involuntary medication, physical restraint, constant observation, and sedative medication. A subsample of 2% of AN patients had more than 100 Involuntary measures recorded. The first recorded Involuntary measure was predicted by most but not all psychiatric comorbidities, especially schizophrenia, autism spectrum, and personality disorders, older age at first diagnosis, and previous admissions. DISCUSSION It is important to develop a more granular understanding of patients at risk of requiring Involuntary Treatment and to determine how best to treat them effectively with minimal use of Involuntary measures.
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a danish register based study on Involuntary Treatment in anorexia nervosa
International Journal of Eating Disorders, 2018Co-Authors: Loa Clausen, Janne Tidselbak Larsen, Cynthia M. Bulik, Liselotte PetersenAbstract:OBJECTIVE Involuntary Treatment is controversial and widely debated, but remains a significant component of Treatment for severe anorexia nervosa. Given how little is known about this topic, we describe the frequency of various Involuntary measures in a national cohort of all patients diagnosed with anorexia nervosa. In a subsample of patients, we explored predictors of the first Involuntary measure recorded. METHOD Descriptive statistics and Cox proportional hazard analyses were conducted using the national registers of Denmark covering the total population. Data from the National Patient Register and the Psychiatric Central Research Register including all psychiatric visits from 1969 onwards were merged with data from the National Register on Coercion covering 1999 onward. Involuntary measures registered between 2000 and 2013 were analyzed. RESULTS A total of 4,727 patients with a diagnosis of anorexia nervosa representing 16,592 admissions were included. Eighteen percent experienced at least one Involuntary measure. A variety of measures were used with tube feeding being the most frequent followed by mechanical restraint, Involuntary medication, physical restraint, constant observation, and sedative medication. A subsample of 2% of AN patients had more than 100 Involuntary measures recorded. The first recorded Involuntary measure was predicted by most but not all psychiatric comorbidities, especially schizophrenia, autism spectrum, and personality disorders, older age at first diagnosis, and previous admissions. DISCUSSION It is important to develop a more granular understanding of patients at risk of requiring Involuntary Treatment and to determine how best to treat them effectively with minimal use of Involuntary measures.
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A systematic review of the frequency, duration, type and effect of Involuntary Treatment for people with anorexia nervosa, and an analysis of patient characteristics
Journal of eating disorders, 2014Co-Authors: Loa Clausen, Allan JonesAbstract:Objective: Involuntary Treatment of anorexia nervosa is controversial and costly. A better understanding of the conditions that determine Involuntary Treatment, as well as the effect of such Treatment is needed in order to adequately assess the legitimacy of this model of care. The aim of the present study was to investigate the frequency and duration of Involuntary Treatment, the characteristics of this group of patients, the kind of Involuntary actions that are applied and the effect of such actions. Review: Relevant databases were systematically searched for studies investigating the Involuntary Treatment of individuals diagnosed with anorexia nervosa. Results: The studies included in the review contained people treated in an inpatient setting for severe or severe and enduring anorexia nervosa. People that were treated involuntarily were characterised by a more severe psychiatric load. The levels of eating disorder pathology between Involuntary and voluntary groups were similar and the outcome of Involuntary Treatment was comparable in terms of symptom reduction to that of voluntary Treatment. Conclusion: Despite inconsistent findings, the comparable levels of eating disorder pathology observed between Involuntary and voluntary patient-groups together with findings of higher co-morbidity, more preadmissions, longer duration of illness and more incidences of self-harm for Involuntary patients suggest that Involuntary Treatment is not a reaction to the severity of eating disorder symptoms alone, but is most likely a response to the complexity of the patient’s situation as a whole.
Brook Buettner - One of the best experts on this subject based on the ideXlab platform.
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Older Adults in the Involuntary Treatment System.
Journal of gerontological social work, 2017Co-Authors: Brook BuettnerAbstract:Dear Editor:The Involuntary Treatment system allows a state to detain an individual against her or his will, and older adults are often differentially affected—especially under grave disability sta...
R. Julian Hafner - One of the best experts on this subject based on the ideXlab platform.
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Attitudes of psychiatric patients and their relatives to Involuntary Treatment.
The Australian and New Zealand journal of psychiatry, 1991Co-Authors: Nicholas H.s. Adams, R. Julian HafnerAbstract:In 1979 a Guardianship Board assumed responsibility in South Australia for the welfare of those mentally ill or handicapped people unable to look after their own health or safety, or to manage their own affairs. This study examines the attitudes to guardianship and Involuntary Treatment of 79 patients referred to the Board from a psychiatric hospital, all of whom were under guardianship at the time of the study. Forty-seven of their relatives took part in the project, which included measures of patients' psychiatric symptoms and relatives' punitiveness. Although almost 70% of patients objected to Guardianship in principle, they made more positive than negative statements about it. Nearly 60% rated Involuntary Treatment, including medication, as helpful. Patients reported a level of psychiatric symptoms less than half of that of a psychiatric outpatient sample. Relatives were strongly in favour of Guardianship, stating frequently that it allowed an improved relationship between themselves and the patient. ...
Marianne Wyder - One of the best experts on this subject based on the ideXlab platform.
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therapeutic relationships and Involuntary Treatment orders service users interactions with health care professionals on the ward
International Journal of Mental Health Nursing, 2015Co-Authors: Marianne Wyder, Robert Bland, Andrew Blythe, Beth Jane Matarasso, David CromptonAbstract:There is increasing evidence that an Involuntary hospital admission and Treatment can undermine the therapeutic relationship. While good relationships with staff are important factors influencing long-term recovery, there is little information on how people experience their relationships with staff while under an Involuntary Treatment order (ITO). Twenty-five Involuntary inpatients were interviewed about their experiences of an ITO. The interviews were analysed by a general inductive approach. Participants described the following themes: (i) the ITO admission was a daunting and frightening experience; (ii) staff behaviours and attitudes shaped their experiences in hospital; (iii) importance of staff listening to their concerns; (iv) importance of having a space to make sense of their experiences; (v) importance of staff ability to look beyond their illness and diagnosis; and (vi) importance of staff working in partnership. These findings highlight that when using recovery principles, such as an empathic engagement with the patients' lived experience, forging partnerships with patients in Treatment decision-making to enhance agency, an Involuntary Treatment order does not have to limit the ability to establish positive relationships.
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The experiences of the legal processes of Involuntary Treatment orders: Tension between the legal and medical frameworks
International Journal of Law and Psychiatry, 2015Co-Authors: Marianne Wyder, Robert Bland, Ann Herriot, David CromptonAbstract:3An Involuntary Treatment order (ITO) allows a person to be treated for a mental illness without consent under some circumstances. While the Treatment and assessment of mental illness are essentially clinical decisions, Involuntary mental health admissions are governed by a framework of legal principles, safeguards and procedures. The underlying philosophy of these laws is based on therapeutic jurisprudence. This approach focuses on the importance of the legal process as a social force and suggests that this can either protect or empower people. The legal processes can however adversely impact upon people's states of mind. This study reports on 25 qualitative interviews with Involuntary inpatients of a major teaching hospital. The interviews were analysed thematically using a general inductive approach. The analysis focused on the patients' general experience of being placed under an ITO and their understanding of the ITO process. Generally, those who described the experience of an ITO in more positive terms, also experienced the ITO as a positive right. In addition to providing them with the Treatment needed, they also felt that the ITO gave them protection and guidance. Conversely, those who experienced being placed under an ITO in more negative or mixed ways, described feeling powerless in the process, as they felt that the ITO took away their rights. By and large the ITO process was experienced as arbitrary when patients did not understand the reasons for their admission. In addition, these patients had limited or no information about their Involuntary Treatment order and they did not know what was expected of them to have the ITO revoked. Most importantly, they did not feel that there were any meaningful legal protections in place. These experiences highlight the importance of the legal processes and how these can be used as clinical tools.
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Therapeutic relationships and Involuntary Treatment orders: Service users' interactions with health‐care professionals on the ward
International journal of mental health nursing, 2015Co-Authors: Marianne Wyder, Robert Bland, Andrew Blythe, Beth Jane Matarasso, David CromptonAbstract:There is increasing evidence that an Involuntary hospital admission and Treatment can undermine the therapeutic relationship. While good relationships with staff are important factors influencing long-term recovery, there is little information on how people experience their relationships with staff while under an Involuntary Treatment order (ITO). Twenty-five Involuntary inpatients were interviewed about their experiences of an ITO. The interviews were analysed by a general inductive approach. Participants described the following themes: (i) the ITO admission was a daunting and frightening experience; (ii) staff behaviours and attitudes shaped their experiences in hospital; (iii) importance of staff listening to their concerns; (iv) importance of having a space to make sense of their experiences; (v) importance of staff ability to look beyond their illness and diagnosis; and (vi) importance of staff working in partnership. These findings highlight that when using recovery principles, such as an empathic engagement with the patients' lived experience, forging partnerships with patients in Treatment decision-making to enhance agency, an Involuntary Treatment order does not have to limit the ability to establish positive relationships.
