Dignified Care Cuts Coercion 50%

What makes an admission to a mental health unit a more or less traumatic experience, and what role do nurses play in this experience? A study recently published in the Journal of Clinical Nursing focuses on a question that is as sensitive as it is little explored: the perception of quality of care as a factor that can make a big difference in mental health care.

When health care is experienced as dignified, safe and collaborative, the feeling of having been coerced and humiliated decreases significantly, according to the conclusions of the study conducted by the NURSEARCH group of the Faculty of Nursing of the University of Barcelona.

The study, which analyzed the experience of 255 people admitted to 12 acute mental health units throughout Spain, is part of the project "Reserved Therapeutic Space RTS_MHNursing_Spain."

It is led by Professor Antonio R. Moreno Poyato, from the UB's Faculty of Nursing. The study data were collected just before patients left the hospital, and both the perceived quality of care and the subjective experience of coercion, humiliation and fear were assessed.

Respect for the patient's privacy and dignity

In mental health care, coercion is not always physical. It often appears as a lack of information, imposed decisions or the absence of intimate spaces to express oneself without fear. This study confirms what many professionals and people have long sensed: The way in which care is provided matters a lot.

The study highlights that aspects such as privacy, security, emotional support and discharge planning are key factors. Among all the factors, respect for privacy and dignity—what the study questionnaire describes as "protected environment"—has the greatest impact on reducing the experience of coercion and humiliation.

"They also emphasize active participation in clinical decisions and discharge preparation, areas in which nurses play a key role when creating therapeutic links and ensuring person-centered care," says Professor Antonio R. Moreno Poyato.

The findings support recommendations from bodies such as the World Health Organization and the World Psychiatric Association to move towards person-centered models of care based on human rights, participation and recovery.

The UB study offers a specific tool for this change: It demonstrates with data that improving the perceived quality of care has a real impact on the experience of hospitalized people.

"Through their daily proximity, nurses can facilitate safe spaces, foster trust and promote care that is free from coercion.

"This change does not always involve more resources, but rather a change in outlook and priorities: caring with respect, guaranteeing intimate spaces, listening actively and offering an emotionally safe environment," concludes Antonio R. Moreno Poyato.