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Use of coercion in mental healthcare services in Nigeria: Service providers' perspective.

Authors
  • Aluh, Deborah Oyine1, 2, 3
  • Ayilara, Olaniyi4
  • Onu, Justus Uchenna5
  • Pedrosa, Barbara1, 2
  • Silva, Manuela1, 2
  • Grigaitė, Ugnė1, 2
  • Santos-Dias, Margarida1, 2
  • Cardoso, Graça1, 2
  • Caldas-de-Almeida, José Miguel1, 2
  • 1 Comprehensive Health Research Centre (CHRC), Nova Medical School, Nova University of Lisbon, Lisbon, Portugal. , (Portugal)
  • 2 Lisbon Institute of Global Mental Health, Lisbon, Portugal. , (Portugal)
  • 3 Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria Nsukka, Nigeria. , (Niger)
  • 4 Department of Clinical Services, Federal Neuropsychiatric Hospital, Uselu, Edo state, Nigeria. , (Niger)
  • 5 Department of Mental Health, Nnamdi Azikiwe University- Nnewi Campus, Awka, Anambra State, Nigeria. , (Niger)
Type
Published Article
Journal
Journal of mental health (Abingdon, England)
Publication Date
Feb 01, 2024
Volume
33
Issue
1
Pages
75–83
Identifiers
DOI: 10.1080/09638237.2023.2182426
PMID: 36850036
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

There is increasing advocacy to reduce coercive practices in mental healthcare. Little research has been done on the topic in developing countries. To explore what mental health professionals in Nigeria think about coercion, why it is used, and what contextual factors influence its use in mental healthcare services. Semi-structured interviews were carried out with 16 doctors and 14 nurses from two psychiatric hospitals in two regions of Nigeria. The audio-recorded interviews were analyzed thematically with the aid of MAXQDA software. Three broad categories relating to the perception of, reasons for, and barriers/facilitators to the use of coercion were derived. Coercion was viewed as being for the best interests of patients, a means to an end, and effective for achieving desired outcomes. Safety was both a reason to use a coercive measure and a deterrent to using specific coercive measures thought to be unsafe. The socio-cultural context, obsolete mental health legislation, staff shortages, and attitudes were factors influencing the use of coercion in mental healthcare. Coercion was perceived to be ultimately beneficial in mental health practice. There is need for a new mental health legislation and more resources for mental health care in Nigeria to address the problem of coercion.

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