Tvang innen psykisk helsevern og ettersamtaler Hvordan oppleves utskrivningssamtalen etter innleggelse på tvungen psykisk helsevern?

Abstract

Background: In the field of mental health, it is an important objective to use less coercion. Political guidelines require less coercion and more user involvement. Law require user involvement. After use of coercive interventions, it is also an important goal to reduce the user’s experience of trauma and humiliation. Implementation of post-event debriefing after admission may be such an intervention. Purpose and research question: The purpose of this study is to gain an insight on to how people who experienced coercion in mental health care experienced the discharge conversation. We wanted their unique experience of user involvement during hospitalization. The research question: "How is the discharge conversation perceived after admission to compulsory psychiatric care? Method and subjects: It is used a qualitative research design, within a hermeneutical and phenomenological context. A semi-structured interview guide was used. The seven interviews were conducted between November 2014 and January 2015. The inclusion-criteria were that the interviewee had previously been under compulsory mental health care. Analysis: In the analysis we used Malteruds text condensation in four steps. We have categorized our findings under four subtopics: The discharge conversation, user involvement, and the experience of coercion and whether admission characterizes life afterwards. We then discussed our findings against Antonovskys theory Salutogenesis and experience of coherence. Conclusion: The value of personal relations stood out in our findings. Everybody pointed at good or bad relations as decisive for how they experienced the admission. The discharge conversation proved useful when user involvement was focused upon thru the admission. Personal interaction with others was found most important. More research on this field is required. User involvement that focuses on personal relations and alternatives to coercion must be put on the agenda. Keywords: Discharge, coercion, debriefing, post-event debriefing and user involvement.