ReviewBJPsych open2026
Patient experiences of coercion in mental healthcare: systematic review and metasummary of qualitative studies from 1991 to 2025.
Review in BJPsych open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
5 authors.
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Abstract
backgroundQuestions have been raised whether the patient organisations assessments of coercion - often critical - captures the breadth of patient experiences of coercion. Existing systematic reviews have not captured the full scope of reported experiences, necessitating a more comprehensive approach.
aimsTo identify the existing body of qualitative studies reporting patients' experiences of coercion; map study distribution over time, regions, and type of coercion; and synthesise broad categories of reported experiences.
methodThe review protocol was preregistered (PROSPERO identifier CRD42021248744). We searched 12 databases (MEDLINE, Embase, APA PsycINFO, CINAHL, Web of Science, Sociological Abstracts, Scopus, ASSIA, Norart, SveMed+, OpenGrey.eu and Google Scholar) for qualitative studies published from 1 January 1991 to 3 June 2025. Peer-reviewed studies and approved doctoral theses were included. We used EPPI-Reviewer for screening, data extraction and coding. Study quality was assessed with a modified Critical Appraisal Skills Programme tool.
resultsWe included 291 studies, 18 of them from low-and middle-income countries. The most studied coercive practices were involuntary admissions, coercive measures and community treatment orders. Quality concerns included limited author reflexivity and lack of involvement of experts by experience. At least one negative experience was reported in 279 of the studies, while mixed and positive experiences appeared in 166 and 167, respectively.
conclusionsA large body of qualitative research reporting patient experiences of coercion exists, with a near-universal presence of negative experiences. Improved patient involvement in research, and more studies from low-and middle-income countries and on involuntary medication are needed.
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