Does coercion matter? Supporting young next-of-kin in mental health care

Abstract

Background: Coercion can cause harm to both the patient and the patient’s family. Few studies have examined how the coercive treatment of a close relative might affect young next-of-kin. Research questions: We aimed to investigate the views and experiences of child-responsible staff (CRS) in relation to the needs of young next-of-kin in coercive situations and to identify ethical challenges. Research design: We conducted a qualitative study based on semistructured, focus group interviews and one individual interview. Participants and research context: We held three focus group interviews with six to seven CRS in each group (a total of 20 participants) and one individual interview with a family therapist. The participants were recruited from three hospital trusts in Eastern Norway. Ethical considerations: The study was approved by the National Data Protection Official for Research and based upon informed consent and confidentiality. Findings: Coercion was not a theme among the participants in relation to their work with young next-of-kin, and there was much uncertainty related to whether these young people need special support to deal with the coercive treatment of their close relative. Despite the uncertainty, the study indicated a need for more information and emotional support among the youth. Discussion: Few studies have addressed the potential impact of coercive treatment of a close family member on young next-of-kin. The findings were consistent with existing research but highlighted disagreement and uncertainty among the CRS about to what extent the young next-of-kin should visit and whether they should enter the ward unit or not. We identified ethical challenges for the CRS related to the principle of not inflicting harm (nonmaleficence). Conclusion: From the perspective of CRS it appears that the coercive treatment of a close family member entails a need for extra support of young relatives both in relation to information and the facilitation of visits, but more systematic knowledge about these issues is needed.