Coercion in Treatment: Researchers' Perspectives
A different perspective is offered in several related articles in the May issue. For example, the study by Link and colleagues (2) suggests that assisted outpatient treatment reduces arrest rates, and Sheehan and Burns (3) report an inverse relationship between perception of coercion and the quality of the therapeutic relationship. Perhaps Dr. LeBel's conclusions would have been more balanced had she also considered these findings. As I suggested in a letter in 2009 (4), and as Link and colleagues (2) discuss in some detail, coercion is not a categorical variable but a dimensional one. As such, it cannot be considered an all-or-nothing phenomenon. Similarly, research into this complex phenomenon, which is potentially present in all relationships, must be multifaceted and must value all relevant perspectives. Although there is certainly a need for research into coercion from a consumer perspective, we know far too little about this complex process to conclude that any research is “flawed” because the researchers are observers but not participants.
Disclaimer
The opinions expressed are those of the author alone and do not necessarily reflect those of the Maryland Mental Hygiene Administration or Springfield Hospital.
1 : Coercion is not mental health care. Psychiatric Services 62:453, 2011 Link, Google Scholar
2 : Arrest outcomes associated with outpatient commitment in New York State. Psychiatric Services 62:504–508, 2011 Link, Google Scholar
3 : Perceived coercion and the therapeutic relationship: a neglected association? Psychiatric Services 62:471–476, 2011 Link, Google Scholar
4 : The role of coercion in public mental health practice (letter). Psychiatric Services 60:1273, 2009 Link, Google Scholar