Experience of coercion among nursing professionals in a medium-stay mental health unit: A qualitative study in Spain

Introduction Creating a therapeutic and safe milieu with the minimum coercive measures requires knowing professionals' perceptions and attitudes towards coercion, but they remain unexplored in medium and long-stay inpatient psychiatric rehabilitation units.Aim To explore the knowledge, perception and experience of coercion among nursing staff at a rehabilitation medium-stay mental health unit (MSMHU) in Eastern Spain.Method Qualitative phenomenological study including 28 face-to-face, semi-structured interviews based on a script. Data were analysed using content analysis.Results Two main themes were found: (1) therapeutic relationship and treatment in the MSMHU, which included three subthemes: qualities of the professionals for building the therapeutic relationship; perceptions about the persons admitted to the MSMHU; views of the therapeutic relationship and treatment in the MSMHU; (2) Coercion at the MSMHU, comprising five subthemes: professional knowledge; general aspects; emotional impact of coercion; opinions; alternatives.Discussion Coercive measures are often normalized in mental health care and considered implicit to daily practice. A proportion of participants who did not know what coercion is.Implications for Practice Knowledge about coercion might influence attitudes towards coercion. Mental health nursing staff could benefit from formal training in non-coercive practice, facilitating the operative implementation of effective interventions or programmes.