A new article published in the Journal of Humanistic Psychology finds that patients often experience forced drugging in psychiatric contexts as dehumanizing and violent. Patients also reported feeling powerless and having their accounts dismissed due to their diagnoses. This research, authored by Mohammed Abdulhussein from Roehampton University in London, also finds that some patients reframed forced drugging as necessary after they began to recover. The author notes that these patients did not report benefits from the drugs at the time they were administered and their reframing of forced drugging may be a coping strategy that allows them to recover lost autonomy. Abdulhussein writes:
“This scoping review synthesises findings from 21 qualitative studies to explore individuals’ experiences of forced medication. The review identifies recurring themes of violence and dehumanisation, epistemic exclusion, protest and survival strategies, powerlessness, retrospective reframing, and a desire for alternatives. Interpreted through the Power Threat Meaning Framework, the review frames forced medication as a manifestation of systemic power that shapes emotional responses, meaning-making, and lived experience.”
This study, published online, is set to appear in an upcoming special print issue of the Journal of Humanistic Psychology on first person psychopharmacology.
Forced Drugging, Adverse Effects, and Human Rights
Forced drugging of psychiatric patients is a controversial but common practice in psychiatry. Past research has found that forced drugging violates patient autonomy, has adverse effects, limited evidence of benefits, and is linked to longer stays and higher readmission rates in psychiatric hospitals. A 2011 paper argues that forced drugging damages therapeutic relationships, reduces treatment effectiveness, and results in increased adverse events due to the nocebo effect.
Patients often report feelings of fear, humiliation, and anger after being forced to take psychiatric drugs. A 2019 study found that forced drugging is often traumatic, causes feelings of violation, and damages trust in psychiatric services. This practice also involuntarily exposes patients to the numerous adverse effects associated with psychiatric drugs, including early death. In 2018, a Norwegian Ombudsman concluded that forced drugging with antipsychotics violated the law due to the low probability of improving patients’ conditions.
The UN has questioned the US on the practice of forced psychiatric drugging, framing it as a human rights violation. A 2020 UN Special Rapporteur on Torture wrote that “involuntary psychiatric interventions based on ‘medical necessity’ or ‘best interests’ may well amount to torture.” Research has found patients that are forced to take psychiatric drugs have insufficient protections and experience power imbalances that favor agents of psychiatry.
A 2020 study out of the US found that patients forced to take drugs against their will were more likely to be black, homeless, and prior victims of abuse. Research from the US has also found that black patients are given PRN (as needed, often involuntary) drugs more frequently, including a 58% increased likelihood of PRN antipsychotics and increased odds of receiving repeated antipsychotic doses. Similar research from the UK found that black patients were significantly more likely to be given higher doses of long-acting injectable antipsychotics.
Study Details
The aim of the current work was to explore the lived experience of being forced to take psychiatric drugs through the lens of the Power Threat Meaning Framework (PTMF), an approach that frames psychological distress and abnormal behavior as logical, understandable survival responses to traumatic experiences and oppression.
The author decided to conduct a scoping review of previous research around the lived experience of forced psychiatric drugging. To be included in the current research, studies had to be published between January 1, 2000 and July 15, 2025, be a peer-reviewed qualitative study or doctoral thesis that focused on the first-person experience of forced psychiatric drugging, and be written in English.
Studies that focused only on clinical outcomes, contained only quantitative data, and those that explored coercion in psychiatry without explicitly examining forced drugging were excluded. Abdulhussein performed a thematic analysis of included research to identify recurring themes related to the lived experience of forced psychiatric drugging. In total, 21 studies were included in the current review.
The author identified six overarching themes throughout the included studies. (1) Forced medication as an act of violence included patient reports of feeling dehumanized, traumatized, and experiencing forced drugging as a physical and psychological violation. Patients described this practice with words like “assault” and “torture.” They also reported long-term emotional blunting and a damaged sense of identity as a result of forced drugging.
(2) Lack of information and epistemic exclusion involved patient reports of a lack of communication around forced drugging. They were given little information around this practice or the administered drugs which led to feelings of confusion and fear. When patients asked questions or complained of adverse drug effects they were routinely dismissed as being delusional and lacking insight.
(3) From protest to survival was a theme related to how patient responses to forced drugging changed over time. Many patients reported initial reactions that involved displays of anger, verbal and physical resistance, and formal complaints. However, they quickly realized that resistance was often used to justify further acts of coercion. The result was many patients using “performative insight,” pretending to agree with mental health staff about their condition, as a survival strategy and to secure release.
(4) Powerlessness involved patients feeling legally trapped with no say over their own treatment decisions. Resistance was seen by mental health professionals in terms of the “illness” rather than as an expression of feeling violated. This loss of autonomy harmed patients sense of self and interpersonal trust. This was especially true when family members approved of the coercive treatment which resulted in feelings of isolation and betrayal.
(5) Retrospective reframing and acceptance referred to some patients reframing their experience of forced drugging after they were in recovery as more positive. Some of these patients adopted psychiatric terms, such as saying their initial resistance was due to a “lack of insight” into their “illness.” Viewed through the PTMF, the author writes that this reframing may be an attempt to reconcile the violations they experienced which could allow for reclaiming of lost agency.
(6) Appetite for an alternative highlighted patients’ strong desire for less invasive and coercive care. Many patients believed that psychiatric services were far too dependent on drugs and could do more good if they focused instead on dialogue, talking therapies, and social approaches. Patients also indicated that crisis teams and safe rooms should be tried before resorting to forced drugging.
In addition to the qualitative findings, Abdulhussein also presents a hypothesis related to forced psychiatric drugging. As the randomized control trials used to evaluate these drugs are performed on willing participants, there is actually very little evidence around forced drugging. The violation of bodily autonomy that accompanies forced drugging may cause stress responses, changes in neurotransmitter levels, and altered liver enzyme activity, which could influence and significantly alter the drug’s effects. The heightened stress and negative emotions around forced drugging can also exacerbate negative outcomes as a result of the nocebo effect.
This research had several limitations. As a result of differing legal and mental health frameworks, the included studies used different measures and definitions of coercion. Many studies also examined coercion more broadly rather than forced drugging specifically. The analysis was performed by a single researcher, meaning there is elevated risk of bias compared to research where analysis is performed and validated by multiple authors. Most included studies came from the UK and Sweden, and included studies had to be published in English. This limits the generalizability of the findings. The author concludes:
“This review shows that forced psychiatric medication is frequently experienced as an act of institutional violence, producing psychological distress, damaging therapeutic relationships, and shaping individual reactions towards medications. The PTMF illuminates these experiences as coherent responses to power, threat, and meaning-making, shifting attention away from narrow biomedical framings. These insights challenge psychiatry’s prevailing focus on symptom reduction and instead call for trauma-informed, rights-based, and relational approaches to care.”
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Abdulhussein, M. (2025). The subjective experience of forced psychiatric medication: A scoping review interpreted through the power threat meaning framework. Journal of Humanistic Psychology. (Link)
Forcing psychiatric drugs onto someone indicates to me that the authorities didn’t respect me as an equal to the psychiatric authorities.
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What is “epistemic exclusion?”
I have a vague notion, but such pretentious jargon really grates on me.
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I don’t understand that term either and wish common sense language would be used.
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I am guessing that “epistemic exclusion” refers to the withholding of relevant information from a client. This may include information on the side effects of brain-disabling neurotoxins or electroshock treatments.
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I’m hard pressed to describe my reaction to forced drugging, under threat of violence to my person. Powerlessness is closest. I walked away from the entire health care industry. It’s about survival. Those people could kill me.
Now, nearly a decade later (drug and symptom free), as an elderly female in this society – my survival conclusion has broadened to conclude that between here and heaven “I have no control over how people treat me”. What I am experiencing is typical of our times. No one has ever apologized for treating me so badly.
Forced drugging has nothing to do with care or healing. It is about power and abuse.
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Amen, Sister!
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It’s good to hear you’re drug and symptom free now. What has been done to you is horrible.
I experimented forced drugging too in a psychiatric ward years ago and it’s still a trauma I haven’t healed yet. It’s almost a mriacle I’m reading this article today in front on my computer, with a clear mind (although still dealing with C-PTSD, due to auther life traumas aswell…)
I wasn’t even violent, on the contrary, I arrived at the hospital against my will, after a suicide attempt. I wasn’t aggressive, rather extremely sad and powerless.
However, I was placed in a seclusion room (except for meal times, which were very difficult to go to since my body could barely move and was extremely sleepy). It’s still a lot of pain to go through this memory.
The words in this are accurate: dehumanizing, no explanations given at any time, traumatizing, coercitive… Most people don’t even know this kind of legal violence exist in my (rich, European) country.
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I completely agree with the findings of this study that affirms how psychiatric hospitals are using violence and torture to achieve a placid oppressed ward community. But this has been said for decades going back through Breggin and Szasz and in the UK by many post war psychologists and psychotherapists. What I wish to do is to describe how an informed consent community and individuality can be achieved. Some people might choose that they wish to try medication. And so an in depth conversation about drugs and their side effects etc. It’s a very simple argument how a ward like this can be achieved.
I have heard psychiatrists and mental health professionals make the argument as to how can they manufacture acceptable standards of behaviour and conformity without the coercive and violent forcing of drugs. My response. When a person comes into a hospital ward often they are put on one to one observation by staff. Here if they display violence towards other patients or staff they can be placed in seclusion until they are settled. And then they can be reintroduced to the ward. This does not require forced drugging. Forced drugging with it’s violence can achieve placidity in a patient much the same as corporal punishment. Or to illustrate if you punched someone in the stomach every morning you could achieve placidity quite quickly. Forced drugging with the threat of increased drugging if one misbehaves is similar. But the use of staff to respect the human rights of the patients in a conversational and observational relationship removes the transgression of human rights and bodily autonomy in a quite simple way to create a hospital regime that respects human rights.
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Punishing for what someone thinks other people
may do? In the future? Really?
Projection?
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