The validity of mental patients' accounts of coercion-related behaviors in the hospital admission process

Charles W. Lidz, University of Massachusetts Medical School
Edward P. Mulvey, University of Pittsburgh
Steven K. Hoge, University of Virginia
Brenda L. Kirsch, University of Pittsburgh
John Monahan, University of Virginia School of Law
Nancy S. Bennett, University of Pittsburgh
Marlene M. Eisenberg, University of Virginia School of Law
William Gardner, University of Pittsburgh
Loren H. Roth, University of Pittsburgh

Abstract

Although the recent development of a measure for perceived coercion has led to great progress in research on coercion in psychiatric settings, there still exists no consensus on how to measure the existence of real coercive events or pressures. This article reports the development of a system for integrating chart review data and data from interviews with multiple participants in the decision for an individual to be admitted to a psychiatric hospital. The method generates a "most plausible factual account" (MPFA). We then compare this account with that of patients, admitting clinicians and other collateral informants in 171 cases. Patient accounts most closely approximate the MPFA on all but one of nine dimensions related to coercion. This may be due to wider knowledge of the events surrounding the admission.