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Studies show that most mental health professionals use informal coercion daily in routine practice. Practitioners use informal coercion more than they are aware, and a study showed it is underestimated. 29–59% of service users report informal coercion, according to studies spanning different regions.
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The patient may be demanded to do what a clinician wants to secure access to goods of monetary value such as housing, money, children, and criminal justice. Conditional access to housing is the most common form of inducement in informal coercion, being report by 15–40% of service users. A study of
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Service providers, such as mental health nurses or psychiatrists, consider informal coercion as a means to promote compliance, which they felt could prevent worsening of symptoms and the need for formal coercion. Professionals felt that informal coercion could encourage individuals to take more
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Valenti, Emanuele; Banks, Ciara; Calcedo-Barba, Alfredo; Bensimon, Cécile M.; Hoffmann, Karin-Maria; Pelto-Piri, Veikko; Jurin, Tanja; Mendoza, Octavio Márquez; Mundt, Adrian P.; Rugkåsa, Jorun; Tubini, Jacopo; Priebe, Stefan (2015).
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informal coercion in housing provision found that 60% of noncompliant service users were excluded from the program. Healthcare worker may use inducements such as cigarettes, drinks, or a walk to persuade patients to take medication.
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55–69% of service users said they perceived interpersonal leverage as fair and 48–60% as effective. Studies show that patients with higher levels of insight were more favourable to coercion. Patients diagnosed with
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with international mental health care workers, workers were found to consider informal coercion effective, but were uneasy about its use. Healthcare workers felt informal coercion was more acceptable in cases of
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surrounding the practice, healthcare workers described behaviour matching formal definitions of informal coercion, but were reluctant to label their behaviour as coercive.
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645:"Informal coercion in psychiatry: a focus group study of attitudes and experiences of mental health professionals in ten countries"
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Judicial leverage, where a service user complies to treatment to avoid legal proceedings, was reported by 11–23% of service users.
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Several hierarchies of informal coercion have been created. Smuzkler and
Appelbaum defined a five-level hierarchy of coercion:
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If the service user has an emotional dependency on the service provider then the clinician can use displays of
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Violence and aggression: short-term management in mental health, health and community settings: NICE guideline
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Pelto-Piri, Veikko; Kjellin, Lars; Hylén, Ulrika; Valenti, Emanuele; Priebe, Stefan (December 2019).
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are more likely to say that informal coercion is taking place, and are more negative about its use.
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Coercion in community mental health care : international perspectives
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