ArticleBMC psychiatry2022
"Voluntary in quotation marks": a conceptual model of psychological pressure in mental healthcare based on a grounded theory analysis of interviews with service users.
Article in BMC psychiatry, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
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Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 39 citations in OpenAlex.
- Informal Coercion Experienced by Adolescents in Mental Health Care-A Systematic Review.International journal of mental health nursing · 2026Pooled it
- A qualitative meta-synthesis of service users' and carers' experiences of assessment and involuntary hospital admissions under mental health legislations: a five-year update.BMC psychiatry · 2024Pooled it
- Understanding the multidimensional barriers to treatment adherence among Iranian patients with hypertension: a qualitative content analysis.BMC public health · 2026Article
- Perspectives and Experiences of Nurses Implementing the Safe Steps for De-Escalation in Acute Mental Health Units.Journal of psychiatric and mental health nursing · 2026Article
- [Voluntariness of requests for assisted suicide].Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz · 2026Review
- Prevalence of Current Clinical Leverage and Association with Perceived Coercion in Outpatient and Community Psychiatric Settings: A First in Canada Study.Community mental health journal · 2025Article
- Unethical conduct as a multifaceted phenomenon in psychiatric care: Nurse leaders' perspectives.Nursing ethics · 2025Article
- Mental health care practitioners' understanding of the policy guideline on 72-hour assessment.Curationis · 2025Article
- Users' Experience of Treatment and Coercion in an Inpatient Medium-Stay Psychiatric Rehabilitation Unit: A Mixed Methods Study.Journal of psychiatric and mental health nursing · 2025Article
- Perceived determinants of the use of coercion in inpatient child and adolescent psychiatry: a qualitative interview study with staff.BMC psychiatry · 2025Article
- Pathways to experienced coercion during psychiatric admission: a network analysis.BMC psychiatry · 2024Article
- Strategies to promote treatment compliance: a grounded theory study with relatives of people with a serious mental health condition.BMC psychiatry · 2024Article
- Factors and Processes Facilitating Recovery from Coercion in Mental Health Services-A Meta-Ethnography.Healthcare (Basel, Switzerland) · 2024Review
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- Article
- Research ethics in practice: An analysis of ethical issues encountered in qualitative health research with mental health service users and relatives.Medicine, health care, and philosophy · 2023Article
- Exploring Patients' Feeling of Being Coerced During Psychiatric Hospital Admission: A Qualitative Study.The Psychiatric quarterly · 2023Article
- A Call for Transformation: Moving Away from Coercive Measures in Mental Health Care.Healthcare (Basel, Switzerland) · 2023Article
- Review
- Persuasion or coercion? An empirical ethics analysis about the use of influence strategies in mental health community care.BMC health services research · 2022Article
Corrections and comments
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Authors and funding
5 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPsychological pressure refers to communicative strategies used by professionals and informal caregivers to influence the decision-making of service users and improve their adherence to recommended treatment or social rules. This phenomenon is also commonly referred to as informal coercion or treatment pressure. Empirical studies indicated that psychological pressure is common in mental healthcare services. No generally accepted definition of psychological pressure is available to date. A first conceptual analysis of psychological pressure focused on staff communication to promote treatment adherence and distinguished between persuasion, interpersonal leverage, inducements and threats.
aimThe aim of this study was to develop a conceptual model of psychological pressure based on the perspectives of service users.
methodsData were collected by means of semi-structured interviews. The sample consisted of 14 mental health service users with a self-reported psychiatric diagnosis and prior experience with coercion in mental healthcare. We used theoretical sampling and contacted participants via mental healthcare services and self-help groups to ensure a variety of attitudes toward the mental healthcare system in the sample. The study was conducted in Germany from October 2019 to January 2020. Data were analyzed according to grounded theory methodology.
resultsThe study indicated that psychological pressure is used not only to improve service users' adherence to recommended treatment but also to improve their adherence to social rules; that it is exerted not only by mental health professionals but also by relatives and friends; and that the extent to which service users perceive communication as involving psychological pressure depends strongly on contextual factors. Relevant contextual factors were the way of communicating, the quality of the personal relationship, the institutional setting, the material surroundings and the level of convergence between the parties' understanding of mental disorder.
conclusionsThe results of the study highlight the importance of staff communication training and organizational changes for reducing the use of psychological pressure in mental healthcare services.
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