Patients' attitudes toward having been forcibly medicated

Bull Am Acad Psychiatry Law. 1996;24(4):513-24.

Abstract

Forced antipsychotic medication procedures are generally perceived to be clinically necessary options, albelt violations of individuals' bodies and autonomy. Previous studies have explored forcibly medicated patients' attitudes concerning these procedures, but as patients were interviewed while still in the hospital, this may have affected their responses. We interviewed consecutively forcibly medicated English-speaking acute-care inpatients after their discharge to the community. The interviews were conducted by telephone by a clinician not involved with their treatment. Of 65 such patients, 7 had already been rehospitalized, 3 could not recall the procedure, and 25 others refused the interview or were not locatable. Of the 30 who were successfully interviewed, only 47 percent had received any forced injections; the remainder had accepted oral medication under duress. Recollecting their experiences, 57 percent professed fear of side effects, 17 percent feared "addiction," and 17 percent objected to others' controlling them. Forty percent recalled feeling angry, 33 percent helpless, 23 percent fearful, 13 percent embarrassed, but 23 percent were relieved. Surprisingly, 60 percent retrospectively agreed with having been coerced, 53 percent stating they were more likely to take medication voluntarily in the future. Other forcibly medicated patients had poorer outcomes, such as rapid readmission or discharge to a state hospital: those patients may have harbored more negative feelings. However, a substantial fraction of the patients who were reached in the community appeared to support having received medication forcibly as inpatients.

MeSH terms

  • Administration, Oral
  • Adult
  • Advance Directives
  • Antipsychotic Agents / administration & dosage*
  • Antipsychotic Agents / adverse effects
  • Attitude to Health*
  • Coercion*
  • Commitment of Mentally Ill / legislation & jurisprudence*
  • Dangerous Behavior
  • Female
  • Humans
  • Informed Consent / legislation & jurisprudence*
  • Injections, Intramuscular
  • Male
  • Mental Competency / legislation & jurisprudence
  • Mentally Ill Persons*
  • Middle Aged
  • New Jersey
  • Patient Satisfaction
  • Psychotic Disorders / drug therapy*
  • Psychotic Disorders / psychology
  • Treatment Refusal / legislation & jurisprudence

Substances

  • Antipsychotic Agents