El papel de la coacción en el tratamiento ambulatorioun estudio transcultural con profesionales de la salud mental

Abstract

Coercion is a pressure or leverage about someone to force his will or behavior. It transcends Mental Health and affects different disciplines such as philosophy, ethics, law or policy. Within the coercive strategies used in the field of Mental Health, we can distinguish between those that are exercised within a regulatory framework, which we refer to as formal measures of coercion (involuntary hospitalization, seclusion, mechanical and chemical restraint) and; others, object of this study, called informal or covert coercion, which are those used as a form of pressure or leverage on the patient, primarily outpatient, and that escape any regulation or law. Appelbaum and Szmukler define four different levels of informal coercion: persuasion, interpersonal leverage, inducement and threat. Although research about coercion in the last thirty years was consistent, the interests to explore the use of informal have increased in the last decade. Moreover few studies reflect professionals’ point of views, and all of them have been published on developed countries focus, ignoring cultural aspects, tradition and psychiatric care organization that can influence on its use..