Enhancing Quality of Care to Reduce Fear and Coercion in Mental Health Facilities

Recent research emphasizes that the quality of care provided in mental health units can significantly influence patients' experiences, particularly in reducing feelings of fear and coercion. Conducted by the NURSEARCH group from the Faculty of Nursing at the University of Barcelona, a study involving 255 individuals across 12 acute mental health units in Spain highlights the critical role of respectful and dignified treatment.

The study, part of the 'Reserved Therapeutic Space RTS_MHNursing_Spain' project and led by Professor Antonio R. Moreno Poyato, assessed patients' perceptions of care just before discharge. It found that when healthcare is delivered with respect, safety, and collaboration, patients are less likely to feel humiliated or coerced.

A key focus of the findings is the importance of maintaining privacy, ensuring safety, providing emotional support, and involving patients actively in discharge planning. Among these, upholding privacy and dignity—described as creating a 'protected environment'—has the greatest impact on minimizing negative experiences like coercion.

The study further notes that coercion in mental health care often manifests as a lack of information, imposed decisions, or the absence of private spaces for expression, rather than physical force alone. Enhancing person-centered care, grounded in human rights and active participation, is essential. Nurses play a pivotal role in this process by creating safe, trusting environments, fostering meaningful therapeutic relationships, and respecting patients' rights.

Implementing these changes often requires a shift in healthcare priorities towards respect, active listening, and safeguarding confidentiality rather than additional resources. As stated by Poyato, "Caring with respect, ensuring private spaces, listening actively, and fostering an emotionally safe environment can significantly transform patient experiences."

Ultimately, improving perceived quality of care not only affirms patients' dignity but also aligns with international recommendations from organizations like the WHO and the World Psychiatric Association, promoting recovery-oriented, human rights-based mental health services.