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

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 health professionals being responsible for supporting young next-of-kin to patients in mental health care (children-responsible staff) in relation to the needs of these 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 an individual interview.

PARTICIPANTS AND RESEARCH CONTEXT:

We held three focus group interviews with six to seven children-responsible staff 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 the eastern part of Norway.

ETHICAL CONSIDERATIONS:

The study was approved by the National Data Protection Official for Research and based on 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 children-responsible staff 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 children-responsible staff related to the principle of not inflicting harm (nonmaleficence).

CONCLUSION:

From the perspective of children-responsible staff, 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.