Patients’ views and experiences of involuntary hospitalization in Greece: a focus group study

ABSTRACT

Involuntary hospitalization of people with mental illness raises important ethical and legal concerns worldwide; however, only a handful of studies have investigated the patients’ perspective in depth. The present study aims at exploring patients’ views about the rightfulness of compulsory admission, their experience of hospitalization and potential interventions for reducing its effect in Athens. Fourteen patients who were involuntarily admitted to a psychiatric hospital in the Attica region and had been discharged one month prior to the group discussion, participated in the study. A focus group design drawing on Interpretative Thematic Analysis was employed. The themes that emerged include conflicting attitudes towards the rightfulness of admission, the absence of patient participation in any form of decision-making, substantial infringement of human rights and patients’ dearth of knowledge about them. Therefore, raising awareness initiatives, adequate training of all involved parties, the integration of psychotherapy in the treatment plan, the creation of a therapeutic milieu and less coercive alternatives to acute psychiatric care were the course of action suggested by patients. In line with this, concerted efforts on the part of patients, their families, clinicians and policy makers should be channelled towards securing strict enforcement of pertinent legislation and advancing patient-centred care.

KEYWORDS:

• Compulsory admissions
• patient rights
• civil detention
• patient-centred care
• patient empowerment

Acknowledgements

Authors would like to thank the people with mental illness who participated in the study as well as Konstantinos Diakonis whose contribution in data interpretation was indispensable.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes on contributors

Stelios Stylianidis is Professor of Social Psychiatry at the Department of Psychology at Panteion University in Athens. He is the founder and Scientific Director (1989–2015) of the Scientific Association for Regional Development and Mental Health (E.P.A.PS.Y.), and from 2016, he is Scientific Consultant of E.P.A.P.S.Y. (nGO). Dr Stylianidis has professional experience (clinical work, research and administration) in France, Italy and Greece. He is a pioneer in Greece in the field of reform of psychiatric services, linking Primary Health Care with psychiatric services in networking optimization. Dr. Stylianidis’ contribution is also significant in the field of user and carer movement in mental health, on both state and international levels.

Lily E. Peppou is a psychologist, working both as a clinician and as a researcher. She holds a BSc in Psychology from the University of Bristol and an MSc in Psychiatry Research from the Institute of Psychiatry, King's College London. She is a psychoanalytic trainee at the Hellenic Psychoanalytic Society and her research interests include psychiatric epidemiology, coercive measures in psychiatry, and the social determinants of mental illness.

Nektarios Drakonakis is a psychiatrist at the psychiatric hospital of Attica “Dafni”. He completed his studies at the University of Brescia in Italy. His research interests lie between mental health, psychiatric rehabilitation and use of coercive measures in psychiatry.

Georgia Iatropoulou is a psychologist interested in clinical practice in mental health and its evidence base. She is a prospective student of the Msc Clinical Mental health sciences programme, UCL, while she completed her studies in Panteion University, Athens, and has also studied in Spain.

Sofia Nikolaidi is a psychologist interested in mental health research and psychiatric epidemiology. She is a student of the MSc Biosatistics, offered by the Medical school of the National and Kapodistrian University of Athens. She has fulfilled her postgraduate degree in the department of Psychology, Panteion University, Athens.

Kyriaki Tsikou is a psychologist interested in psychiatric research and in community mental health services. She completed her postgraduate studies in the department of Psychology, Panteion University, Athens.

Kyriakos Souliotis is Associate Professor of Health Policy at the Faculty of Social and Political Sciences, the University of Peloponnese. He also teaches courses at the Medical School of the University of Athens and the Medical School of the University of Crete. From July 2017, he is Senior Associate Director at the Medical Technology Research Group of the LSE Enterprise. His research interests include health policy, access to healthcare, patient empowerment and health economics.