Unlocking Advocacy: Exploring Attitudes Towards Coercive Mental Health Practices

Christian Porter and Shannon Pagdon

Coercion in mental health services ranges from pressure during treatment to explicit threats and legal mandates aimed at forcing individuals to receive various treatment against their will (Szmukler, 2015). This coercive spectrum extends to practices such as involuntary psychiatric hospitalization and court-ordered outpatient treatment (assisted outpatient treatment or AOT) where legal frameworks dictate treatment decisions. In this workshop, we aim to understand associations between attitudes of expansion and abolition of coercive mental health practices within mental health advocacy. The original survey, distributed within the United States, focused on mental health advocacy, exploring the motivations behind individuals entering this field, their identity as advocates, and their personal experiences with mental health. Using a nested regression model, we analyze five key blocks including variables drawn from existing literature on mental health advocacy. These include: 1. Experience with involuntary treatment; 2. Current mental health management; 3. Perceptions of stigma and motivation; 4. Subjective experiences with mental health services; and 5. Connections with mental health differences. Through this analysis, we aim to predict attitudes towards the expansion and abolition of involuntary psychiatric hospitalization and AOT. Throughout the exploration of attitudes towards both the abolition and expansion of coercive treatments, it becomes evident that subjective experiences consistently exhibit one of the most significant associations.


  •  Understand how personal history of mental health services, perceived experiences, and connections with others may predict abolition and expansion attitudes of each practice amongst mental health advocates.
  •  Explore the various forms of coercive practices, including involuntary psychiatric hospitalization and court-ordered outpatient treatment, and their implications for individuals receiving treatment.
  •  Expand on implications for mental health policy and advocacy based on the survey findings, with a focus on reducing coercive practices in mental health services.