Perceptions of coercion of patients subject to the New Zealand Mental Health (Compulsory Assessment and Treatment) Act 1992

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dc.contributor.advisor Dr Sandy Simpson en
dc.contributor.advisor Dr John Coverdale en
dc.contributor.advisor Professor Rob Kydd en McKenna, Brian G. en 2008-12-02T22:27:05Z en 2008-12-02T22:27:05Z en 2004 en
dc.identifier.citation Thesis (PhD--Psychiatry)--University of Auckland, 2004. en
dc.identifier.uri en
dc.description.abstract The use of mental health legislation to determine involuntary treatment for people suffering from mental illness (civil commitment) is a controversial issue, centred on the ability of civil commitment to be coercive by limiting patients’ choice, autonomy and self-determination The intent of the New Zealand Mental Health (Compulsory Assessment and Treatment) Act 1992 was to limit coercion by emphasising informed consent (even if treatment can be administered without it); recognising the civil rights of patients subject to civil commitment; and encouraging involuntary treatment in the least restrictive environment (the community). However, there is no evaluative research that considers the extent to which patients subjected to the legislation perceive coercion. The aim of this thesis was to consider the extent to which mental health legal status equates with coercion, the factors that impact on patients’ perceptions of coercion and the factors that have the potential to ameliorate such perceptions. Empirical cross-sectional comparison studies, measuring perceived coercion using a validated psychometric measure, were undertaken at three points during the implementation of civil commitment. These involved a comparison between involuntary and voluntary patients admitted to acute inpatient psychiatric services, a comparison between involuntary patients admitted to acute psychiatric inpatient services and involuntary patients admitted to forensic psychiatric services, and a comparison between involuntary and voluntary outpatients. The studies found that legal status is only a broad index of the amount of coercion perceived by patients. Some voluntary patients feel coerced and some involuntary patients found the process non-coercive. Perceptions of coercion cannot be fully explained by socio-demographic and clinical characteristics, or by coercive incidents that occur throughout the process of civil commitment. Rather, the perceptions relate to the total experience of civil commitment, including the interactive processes with clinicians. In this regard, involving patients in proceedings that are experienced as fair and just (procedural justice) has a marked impact on reducing patients’ perceptions of coercion. In conclusion, the findings are underscored by legal requirements and ethics in order to provide clinical guidelines for implementing civil commitment. en
dc.format Scanned from print thesis en
dc.language.iso en en
dc.publisher ResearchSpace@Auckland en
dc.relation.ispartof PhD Thesis - University of Auckland en
dc.relation.isreferencedby UoA1490518 en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. en
dc.rights.uri en
dc.title Perceptions of coercion of patients subject to the New Zealand Mental Health (Compulsory Assessment and Treatment) Act 1992 en
dc.type Thesis en Psychiatry en The University of Auckland en Doctoral en PhD en
dc.subject.marsden Fields of Research::320000 Medical and Health Sciences::321000 Clinical Sciences::321021 Psychiatry en
dc.rights.holder Copyright: The author en
pubs.local.anzsrc 11 - Medical and Health Sciences en Faculty of Medical & Hlth Sci en

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