Showing papers by "John Monahan published in 1995"

Perceived Coercion in Mental Hospital Admission: Pressures and Process

Abstract: Background: Patients' perceptions of coercion in admission may affect their attitude toward subsequent treatment, including their inclination to adhere to treatment plans. This study looks at the determinants of patients' perceptions of coercion. Methods: A sample of 157 patients admitted to a rural Virginia state hospital and a Pennsylvania community hospital were interviewed within 48 hours of admission about their experience of coming to the hospital. All subjects were 17 years or older. Diagnoses were diverse, and 42% were involuntarily committed. The interview gathered an openended description of the admission experience followed by a structured interview that included several measures. Results: Perceptions of being respectfully included in a fair decision-making process ("procedural justice") and legal status were most closely associated with perceived coercion, and a significant relationship was found with perceived negative pressures, ie, force and threats. However, only procedural justice was related to the perception of coercion at both sites and with both voluntary and involuntary patients. Conclusions: Patients' feelings of being coerced concerning admission appears to be closely related to their sense of procedural justice. It may be that clinicians can minimize the experience of coercion even among those legally committed by attending more closely to procedural justice issues.

Probability, danger, and coercion: A study of risk perception and decision making in mental health law.

Abstract: Young adults were shown hypothetical stimulus vignettes describing mental patients and were asked to judge (a) the probability that the patient would harm someone else, (b) whether or not the patient should be categorized as “dangerous,” and (c) whether coercion should be used to ensure treatment. Probability and dangerousness judgments were systematically related and were predictive of the judged necessity for coercion. However, judged probability was strongly dependent on the form of the response scale, suggesting that probability was not represented consistently and quantitatively in participants' minds. Study 2 replicated these findings with forensic clinicians as participants. These results underscore the importance of violence to others in mental health law and have important implications for the manner in which risk assessments are formulated for use by the legal system.