Patients with schizophrenia and their experiences with legally mandated treatment

ABSTRACT:

Background:  

Schizophrenia is a psychiatric disorder that affects approximately 1% of people worldwide and is a leading cause of disability.  Individuals with schizophrenia often experience emotional, cognitive, and behavioral symptoms.  Patients with severe forms of psychiatric illness, including schizophrenia, may be legally mandated to receive treatment – which typically occurs if they pose a risk to themselves or others.  We aim to describe the experiences of patients with schizophrenia and related disorders who were legally mandated to undergo psychiatric treatment.

Methods: 

Four electronic databases were searched for themes related to schizophrenia, legally mandated treatment, and patient experience.  Studies where at least 50% of participants had a diagnosis of schizophrenia were included.  Qualitative studies that reported on the experiences of patients who underwent any form of legally mandated treatment were included.  We categorized study results as reporting on positive and negative patient experiences.  Additional subthemes were identified.  The quality of each of the included studies was evaluated.

Results: 

The database search identified 4008 abstracts.  Eighteen studies with 401 participants were included in this systematic review of qualitative studies.  Each publication explored different aspects of patients’ experiences with variations of legally mandated treatment.  All studies, except for one, were rated as high quality. Results were categorized under the two broad themes of positive and negative patient experiences.  Patients were satisfied when their autonomy was respected, and dissatisfied when it was not.  Patients often recognized that their treatment was beneficial, but also disliked a lack of communication and information regarding their treatment.

Significance:  

Undergoing legally mandated treatment is a complex process.  Research has traditionally focussed on clinical and quantitative treatment outcomes.  Thus, this study provides insight into the qualitative aspects of patients’ experiences with legally mandated treatment. Recognizing these experiences can lead to better attitudes towards treatment for patients with schizophrenia and other psychiatric illnesses.  Understanding patients’ experiences may improve patient-provider relationships and lead to increased treatment compliance, and as a result, better treatment outcomes.

AUTHOR BIO: 

Joanne Plahouras is completing her Master of Science at the University of Toronto.  She has a strong interest in mental health and has chosen to focus her thesis project on patients with schizophrenia.  This interest in helping others has translated to both working as a Teaching Assistant and her volunteering as a Crisis Responder with Kids Help Phone.  In her spare time Joanne can be found playing soccer and competing with her university's varsity mountain biking team. 

jplahouras@outlook.com

INFO: 

This event is part of the Café Bioethics and Canadian Bioethics Society JUNE PARTNERSHIP Series! CB and CBS are collaborating for the first time in an effort to fill the summer conference gap created by the COVID-19 pandemic. We hope to provide students a platform to share their bioethics  research in an accessible manner, all while creating connections and building their network. Be sure to join us for the series!