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Social Psychiatry and Psychiatric Epidemiology
Published in: Social Psychiatry and Psychiatric Epidemiology 5/2016

Open Access 01-05-2016 | Original Paper

“Care or control?”: a qualitative study of staff experiences with outpatient commitment orders

Authors: Bjørn Stensrud, Georg Høyer, Gro Beston, Arild Granerud, Anne Signe Landheim

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 5/2016

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Abstract

Purpose

Outpatient commitment orders are being increasingly used in many countries to ensure follow-up care of people with psychotic disorders after discharge from hospital. Several studies have examined outpatient commitment in relation to use of health care services, but there have been fewer studies of health professionals’ experiences with the scheme. The purpose of this study was to examine health professionals’ experiences with patients subject to outpatient commitment.

Methods

This was a focus group study using a descriptive and exploratory approach. The study was based on three focus group interviews with a total of 22 participants. Data were analysed using qualitative content analysis.

Results

The study showed that health professionals had a positive attitude towards outpatient commitment and considered it necessary for patients with psychosis who lacked insight and did not collaborate on treatment. At the same time their attention to patients’ lack of insight could lead to a paternalistic approach more than measures to enhance patient autonomy. This challenged their therapeutic relationship with the patient.

Conclusion

Health professionals found it difficult to combine control with therapeutic care, but gave greater emphasis to patients’ need for treatment and continuity of care than to their autonomy. This dilemma indicates a need to discuss whether increased attention to patients’ autonomy rather than insight into their illness would improve treatment cooperation and reduce the use of coercion.
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Metadata
Title
“Care or control?”: a qualitative study of staff experiences with outpatient commitment orders
Authors
Bjørn Stensrud
Georg Høyer
Gro Beston
Arild Granerud
Anne Signe Landheim
Publication date
01-05-2016
Publisher
Springer Berlin Heidelberg
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 5/2016
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-016-1193-8

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