Involuntary hospitalization for treatment: Triangulation of Perspectives of patients, relatives, and professionals

BACKGROUND: An involuntary hospitalization (IH) for treatment purpose is initiated when a person refuses admission while clinicians consider them severely mentally ill and in urgent need of treatment to improve their condition. Qualitative studies of IH patients show that patients later describe mixed experiences and consequences of IH. No study has examined in-depth with views from different perspectives what the disagreement on need of care consists of. AIM: This study wants to explore convergences and divergences in perspectives within triads of patients with non-affective psychosis involuntarily hospitalized for treatment purpose, their relatives, and professionals involved in the same IH focusing on the period prior to IH, experiences of hospitalization, and the outcome of IH. METHOD: Qualitative interviews were conducted when the patients were in a stabilized phase. The description of each patient's condition in the chart was discussed with the patient in question. Interviews were thematically analysed, and the three different perspectives were triangulated. RESULTS: We found divergences within triads on the need for and outcome of IH, the notion of illness, and the expectations of the hospital treatment. Most patients did not feel ill or in need of treatment. Most professionals and relatives deemed IH necessary, but many relatives were dissatisfied with the outcome. All participants emphasized the hospital's lack of capacity. CONCLUSION: This triangulation study on IH highlights the complexity of this intervention, revealing a fundamental divergence between the perspectives of patients, experiencing their psychotic condition as meaningful, the hospital system responding primarily with a medical perspective, and the relatives desiring a more personalized approach.