Så kan tvång undvikas i vården av självskadebeteende - Hur sex kvinnor utifrån sina erfarenheter av psykiatrisk vård tänker att tvång kan undvikas

Sammanfattning: The use of coercion is common in psychiatric care for patients with self-injurious behaviour. These patients are seldom asked about their experiences of being cared for, and even less about their experiences of coercion. The aim of this study was to examine these patients’ experiences of being subjected to coercion in psychiatric care and how they think coercion can be avoided. Semi-structured interviews were conducted with six women and Interpretative Phenomenological Analysis was used to analyze the data. Four themes were identified: To have a voice; Distribution of control and responsibility; Voluntary treatment must remain voluntary; Healthcare that is anchored in real life. Constant surveillance was described as the most destructive coercive intervention. Negative experiences resulted in avoidance of healthcare services. To reduce coercion in psychiatric care, the informants highlighted the importance of seeing the patient as able to take responsibility; including, informing and listening to the patient; increasing knowledge about iatrogenic effects, and understanding that threatening to use coercion is coercive. This study enables a wider perspective on what is to be considered coercive in psychiatric care and presents concrete examples of how increased knowledge about self-injury can be a major contribution in the effort to avoid coercion in psychiatric care.