Before Involuntary Commitment: Coercion in the Shadows

New study reveals that psychiatric force is frequently applied long before formal admission procedures begin.

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Coercion in psychiatry often begins long before patients cross the hospital threshold, a new study reveals. A recent analysis from Bielanski Hospital in Warsaw found that more than half of psychiatric inpatients experienced coercive interventions—either formal or informal—before formal admission.

The research, detailed in the International Journal of Law and Psychiatry, uses a survey of 318 psychiatric inpatients to uncover how threats, manipulation, police involvement, and physical force contribute to hospital entry. These steps, the authors argue, reflect a broader system of social control that begins outside the official walls of mental health institutions.

The authors distinguish two forms of pre-hospital coercion: formal coercion—like police intervention or forced ambulance transport—and informal coercion, including threats, psychological pressure, deception, or manipulation by clinicians, family members, or others.

Over 53 percent of participants reported some form of pre-admission coercion: 45 percent describing informal coercion and 8 percent formal coercion. Men were more likely to report physical coercion, while women reported higher rates of psychological pressure, underscoring how coercion operates differently across gender lines. In addition, individuals with more stigmatized diagnoses—such as schizophrenia or substance use disorders—were more likely to experience physical coercion, and older adults faced higher rates overall.

“Physical or legal force was used: by personnel at admission in 33 %, by other medical staff in 29 %, by the police and security in 40 %, family and relatives in 12 %, other people in 11 %. The police used negative symbolic pressure in the 68 % of cases, staff at admission in 33 %, other staff in 23 %, and family and friends in 20 %,” the authors detail.

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Laura López-Aybar
Laura López-Aybar is a critical psychology psychiatric survivor, researcher, and professor with a PhD from Adelphi University. Her work is propelled by a critical, decolonial, and feminist perspective on psychology. Moreover, she currently leads various projects examining stigma, mental health discourse, and social determinants of health. She co-founded Mad in Puerto Rico and works as a professor at Universidad del Sagrado Corazón and as a researcher for Taller Salud.

38 COMMENTS

  1. Help. Im being held hostage in an establishment run by a for profit installation called Pro Persona. I have no previliges cannot call my 95 year old mother in the old age home etc etc etc.

    Pro Persona in Nijmegen, the Netherlands. They are all cowardly brutes.

    Thats it cannot access this email either. They are purely for profit brutes.

    Snakes and Ladders and the viper is on holiday. Cruel beasts.

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  2. In 2017 I settled with my two parents in the Netherlands Beuningen. Eventually, in 2018, my elderly father and I were alone my mother having broken an upper leg bone after a fall and was rehabilitating, 4 months alone with a severely demented father I being according to them a schizophrenic. Eventually I snapped under pressure and had 2 epileptic seizured it literally felt i was in a dark hole with no end in sight. The local doctors thought it was all a big joke. later i applied for social support. they classified me retroactively as being 100 perc incapable of working dating back to 1990 which was when i was living abroad in portugal. The medical inspector at the UVW NIjmegen stated in a letter dating 2021 that i was fine and taking care of my sick father he had already died in November of 2019. To me that is a sick joke. i literally gave up its 2025 and i am locked up again my mother being in a care home.

    today is 26 07 2025 40 mins past midnight. i can go on Steve if the story is of any interest.

    All my medical records here are forgeries.

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  3. it is now 1 hour past midnight on the third night here. i was coerced to come to this god forsaken place by two middle eastern men in a white van with a dark interior. i am a frail 60 kilo man of middle age they forced me into the van using their arms and hands this was definitely without consent the outside of the van says GGZv waiting.

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  4. in 2017 i needed a perscription for 10mg olanzapine that is when i met sjaaky the shock dock. i found out later he was partially responsible for bringing electroshock treatment to the far east he coerced me into 6 sessions of treatment he got 1500 euros from it he then referred me to the anti christ Pro Persona and stated that if i were to try suicide i should wait until i was in treatment with these people from Pro Persona it wouldnt be good for his image

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    • unless there is a misunderstanding, the 6 sessions were not for electroshock, but because the insurance wouldnt cover the costs of writing out a perscription for a box w 10mg olanzapine he told me that i should call my insurance company to tell them i needed to complete the 6 sessions i have his letter to pro persona and my local gp somewhere here FOR a measly 1500 euros i got a box of 28 10mg pills it is now almost 7 AM

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  5. it is a country the netherlands with mostly honest hard working people this kind of lowly enterprise must come to an end i am all for a sort of half way house where younger people can find a safe haven until they feel confident enough to begin earning money for themselves and not rely on the parasites for crumbs.

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  6. before the GGZ van arrived there was indeed a police van with all the correct colors and POLITIE written on it What came out to threaten me was what looked like a bouncer from one of those shady clubs and a very nervous also middle eastern man with a very shiny gun which didnt look real to me

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  7. This blog largely points out the impropriety of psychologists functioning as funnels into the force drugging psychiatric industry, and why they shouldn’t be doing that. Not to mention, why neither the psychologic nor psychiatric industries should have a right to coerce or force neurotoxic poison anyone.

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  8. 10 47 AM just got a visit from a young psych doctor and what looked like a very immature young doctor my estimate is that she is 2nd or 3rd gen turkish here and the young man was pure dutch with no understanding of culture. Basically a threat to get me in a very secure area somewhere on the complex i had a coffee before so i would come across as what they seem to refer to as paranoid or agitated.

    Lets see what happens next. Not hard to locate me on a map

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  9. 12 09 the two are now threatening with a needle. I presume a long acting one. Being nearly 60 and no family far or near coming to my aid I would prefer the other one to get rid of all the nagging from the folks with conflicting interest

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  10. 12 44 PM the doctors and psychiatrists i have met only want to divulge their first name none seem to be familiar with the local burgemeester. Still threatening with a needle i would prefer the permanent one given only those two options or a street urchin whatever it takes

    it seems the youngish nurses have no qualms injecting anything in me the plot is thickening.

    up till now it does indicate cowardly behavior on the part of the so called professionals

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  11. it is now 13 36 pm they circled around me and closed the exit in a central enclosed area of the building it was predictable if you enjoy those scenes in a zoo where they have to capture the runaway frightened monkey. the only way to escape was swallowing 20mg olanzapine if they keep this up i will become dreadfully ill i wonder if recovery is even possible at this stage

    they have euthanasia for people who see no future that could still be an option it usually takes about two years but you never can tell with these people

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  12. they think the 20mg has made me docile and they are confidently walking around and telling me to keep the noise down wrt my laptop speakers. amazing how dumb they really are. its about 14 20 about 30 mins after the pill wonder if they will start pestering me again the mayor is nowhere to be found how will i remain awake till the sun goes down what will be in store for me tomorrow doctors shrinks and vets mostly have 0 appreciation of nature unless it is in a zoo which is most likely what this is to them caviat being their poison remedies

    the main trick from their view is that the monkey asked for it him or herself just because they can write any report they wish

    hence the forged documents

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  13. another observation it seems if you ask the wrong person a question, there is a separation of tasks, they will listen but then come with a dismissive comment and walk away. I imagine they write or tell a colleague so they have more info. waiting for their next approach. i imagine they will think that i will be more docile tomorrow and accept the pill given they had to be certain i took it today will wait and see no family here only a very elderly mother they can keep this up indefinitely

    who is moderating these comments by the way

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  14. 22 17 in the evening 26 07. Seems they are content for now w 20mg olanzapine, they might insist on the lorazepam. a lot of ignorance on their part. i imagine monday will be scorpion time again. here since thursday afternoon or morning not quite certain. what went on in the days leading up to the internment doesnt seem to an issue with them.

    there was someone who said he was a lawyer never left a card said i had some rights to complain after the 3 days of internment

    sunday should be a day of rest.

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  15. 18 30 Sunday, they insist on the 20 mg sometime tonight, the lorazepam being optional until now, not a good idea taking lorazepam so early 5 hours before going to bed if one doesnt feel agitated in some way. Tomorrow apparently a judge is supposed to come here for me. Doubt very much it is a real judge given the bizarre interview I had with the so called legal council.

    Will see how this develops. 4th night here coming up. If the text at any time seems more poetic it is probably literally because they are in the process of trapping me behind some closed area. I get along quite well with others when I have a better understanding of why they are here. Most are about 20 to 30 years younger which could be a plus. But one does remain apprehensive.

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  16. possibly some plot on the horizon they are waiting till about 10 to 11 PM to administer the olanzapine less chance of dependence in just a few days 20 15 pm now Income stream is especially necessary for the psychiatrists i estimate over 2000 active in this country average salary quite high.

    Psychs tend to get quite touchy when asked about details of any particular neuroleptic, wonder why … conrtast 1 in 3000 in the 30s 40s to 1 in 100 or 200 today

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  17. 10 20 am some nut job somewhere is still insisting on 20 mg to me it would be the equivalent of pouring coca cola on my brain. no one seems to understand what half life of olanzapine means. if they continue it only means early dementia is what they hope for with this cat and mouse game.

    For those unaware it opens the blood brain barrier. half life could be somewhere around 20 to 50 hrs.

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  18. My suspicions confirmed, its the lanky long haired pot bellied pointy shoed psychatrist who without knowing me is writing the receipt for 20 mg olanzapine every day indefinitely with a threat of lorazepam. Im entitled to a court hearing, that much i do know. Now its 13 15 PM Some hearing is theoretically scheduled for 14 30 about an hour from now

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