People who are admitted to Irish psychiatric hospitals often perceive the admission process as coercive, however their caregivers - usually their parents - are less likely to see it in the same way, a new study has found.

Coercion is the act of making someone do something by using force, threats or intimidation.

Researchers from Trinity College Dublin (TCD) and NUI Galway decided to look into perceptions of coercion within the Irish mental health system. They assessed the perspectives of 66 people who were admitted to five different acute, inpatient psychiatric units. Some 71% were admitted involuntarily and almost half had been diagnosed with schizophrenia or schizoaffective disorder.

The perspective of the patients' caregivers was also examined. The majority of caregivers in the study were the parents of the patients.

The researchers focused on perceptions of coercion and procedural justice relating to hospital admission. They found a big difference between how the patients perceived the admission process, and how the caregivers perceived it.

Caregivers tended to perceive the it as less coercive than the patients. They also tended to view the process as more procedurally just than the patients.

"The purpose of this research is not to identify who has a ‘correct' or ‘incorrect' perception of coercion, but rather to identify if there is a disparity between perceptions that could have implications for the future care of service users. For example, caregivers may not understand a service user's reluctance to be readmitted to hospital, as the caregiver may have perceived an earlier admission as less coercive and more procedurally just," explained Veronica Ranieri of TCD, who conducted the research.

She said that one way to tackle these differences in perception is to allow both the patients and the caregivers to share their perceptions of the admission process prior to the patients' discharge.

"The development of strategies to reduce the risk of future admissions and creation of advanced care directives on how the service user would like to be treated if there was a future relapse in their mental health and if a future admission was required, could be encouraged as a means of aiding and preventing future readmissions," she said.

She pointed out that currently, there is a high rate of readmission to inpatient psychiatric units, with around 20% of involuntary admissions being readmitted within one year.

Ms Ranieri noted that the differences in perceived coercion may often be due to difficulties in communication. She said there is a need for more family education in this area that informs and teaches caregivers about skills or strategies that could be used if a readmission of their loved one is required in the future.

The most recent figures available show that in 2013, there were almost 18,500 psychiatric admissions in Ireland. Around 2,100 of these were involuntary.

Details of these findings are published in the journal, Psychiatry Research.