The Validity of Mental Patients’ Accounts of Coercion-Related Behaviors in the Hospital Admission Process
Although the recent development of a measure for perceived coercion has led to great progress in research on coercion in psychiatric settings, there still exists no consensus on how to measure the existence of real coercive events or pressures. This article reports the development of a system for integrating chart review data and data from interviews with multiple participants in the decision for an individual to be admitted to a psychiatric hospital. The method generates a "most plausible factual account" (MPFA). This account is then compared with that of patients, admitting clinicians, and other collateral informants in 171 cases (mean age 35.2 yrs). Patient accounts most closely approximated the MPFA on all but 1 of 9 dimensions related to coercion. This may be due to wider knowledge of the events surrounding the admission. Findings suggest that none of the available reports examined—clinical, collateral, or patient—are totally adequate sources of data about coercion-related behaviors.