Coercion and Influence in Psychiatric Services: Frameworks and Future Directions

• Psychiatric services include various forms of treatment pressures that seek to influence or undermine the decisional autonomy of patients to gain compliance, including coercion. • The definition of coercion has evolved with time, and current debates concern whether nonthreatening treatment pressures (such as incentives) can be considered coercive. • The author proposes distinguishing between interpersonal coercion, which describes clinicians leveraging threats, and institutional coercion, which describes instances in which a patient’s ability to make choices is restricted by social systemic forces.