Aims and method To assess how common the subjective experience of coercion is in psychiatric care and what affects its prevalence. A review of published data was undertaken to assess prevalence of coercion and potential confounding variables. The heterogeneity of results was studied using meta-regression to quantify the relative impact of four potential explanatory variables.
Results The raw prevalence of perceived coercion ranged from 16 to 90%. A quarter of legally detained patients did not feel coerced into psychiatric care, whereas a quarter of voluntary in-patients reported coercion in care. Coercion was more common in studies outside the USA, among patient populations subject to legal detention and populations studied using the MacArthur Perceived Coercion Scale as opposed to other measures. Timing of the interview was not associated with coercion.
Clinical implications Coercion in psychiatric care remains highly prevalent but varies widely by study. Consistency in measurement is necessary to allow better comparison between studies.