Influence of mental health professionals’ attitudes and personality traits on decision-making around coercion: Results from an experimental quantitative survey using case vignettes

Abstract

Objective: Research on coercion in mental healthcare has recently shifted to the investigation of subjective aspects, both on the side of the people with mental disorders affected and the staff members involved. In this context, the role of personality traits and attitudes of staff members in decision-making around coercion is increasingly being assessed. This study aimed to examine the role of staff attitudes towards coercion and staff members’ personality traits in decision-making around coercion in an experimental setting. Methods: We assessed the attitudes towards coercion and (general) personality traits of mental health professionals in psychiatric hospitals with a quantitative survey. Furthermore, we developed case vignettes representing cases in a ‘grey zone’ and included them in the survey to assess staff members’ decisions about coercion in specific situations. Results: A general approving attitude towards coercion significantly influenced decisions around coercion in individual cases—resulting in a more likely approval of applying coercion in the cases described in the vignettes. Personality traits did not seem to be relevant in this regard. Conclusion: Strategies to reduce coercion in mental healthcare institutions should focus more on the role of staff attitudes and encourage staff members to reflect on them critically.