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FRIMEDBIO-Fri prosj.st. med.,helse,biol

The complexity of coercion in child and adolescent psychiatry (CAP)

Alternative title: Tvang i barne- og ungdomspsykiatrien

Awarded: NOK 12.0 mill.

Project Number:

313731

Application Type:

Project Period:

2021 - 2026

Subject Fields:

Partner countries:

The aim of the project is to provide new knowledge of the use of coercion in adolescent psychiatric wards in Norway. Despite a strong professional and political focus on the treatment of children and adolescents with mental disorders, the use of coercion in adolescent psychiatry is an under explored field. The scarce Norwegian research that exists in the field shows that a small group of the admitted young people are exposed to a large part of the coercion used in the units. With an increased focus on user participation and human rights, and growing evidence of the negative consequences of coercion used in psychiatric institutions, it is important to gain a nuanced understanding of coercion. It is especially pivotal to study how children and adolescents are exposed to coercion since this group of patients is particularly vulnerable to violations of their will, autonomy and integrity. A main ambition in the study is to develop a holistic understanding of how coercion is used and experienced by combining social science, health science and legal perspectives. Such an interdisciplinary focus makes it possible to examine how coercion involves formal legislation and guidelines, treatment and control of unwanted behavior. The project will map the extent of coercion and the types of coercion used in adolescent psychiatric wards. The project will also investigate why and how coercion is used and experienced by both staff and patients. Among other things, we will carry out a longer ethnographic fieldwork in two selected units. The project will produce new knowledge about coercion and its consequences for staff and patients. This will provide new perspectives on treatment in mental health care. The project will disseminate the results to a scientific audience, users, professionals and the general public. It is a key goal to increase public awareness of coercive practice in psychiatric units

Despite a substantial focus on the treatment of children and adolescents with mental illness, little is known about the use of coercion in child and adolescent psychiatry. The primary objective in the study is to fill a knowledge gap by producing a new multi-dimensional understanding of coercion in children and adolescent acute psychiatric inpatient units in Norway that involves legal, social and cultural aspects. The project will investigate coercion as a complex social phenomenon that simultaneously aims at treating, protecting and controlling the individuals who are subject to it. The study will utilise theories that address how life in closed institutions is governed and regulated, and will be based on a mixed-method design, applying both quantitative and qualitative methods. Collection of secondary data, surveys, interviews and ethnographic fieldwork will used to achieve the two secondary objectives: i) to uncover the extent of compulsory admissions and coercive measures in institutions approved for compulsory mental healthcare, and ii) to provide knowledge of how coercion is exercised and experienced in adolescent acute psychiatric inpatient units from the perspective of both patients and professionals. Challenges in the study relate to the fact that the project will explore one of the most sensitive user groups and issues in health services in the welfare state. This calls for rigorous ethical and judicial considerations and for the development of a sensitive methodological approach in the study. Accordingly, a pivotal element in the study is to involve co-researchers with user experience throughout the research process. The project results will facilitate new understandings of why and how coercion is practised and experienced in adolescent psychiatry, and provide updated knowledge of the form, function and extent of coercive measures in adolescent psychiatric inpatient units.

Funding scheme:

FRIMEDBIO-Fri prosj.st. med.,helse,biol

Funding Sources