Mental Health Workers Say They Want Recovery-Oriented Care. So Why Do They Still Endorse Involuntary Treatment?

A new study published in BMC Psychiatry sheds light on the deep ambivalence among mental health professionals regarding the use of involuntary psychiatric hospitalization. Though many clinicians advocate for community-based, recovery-oriented approaches, most still regard coercive admission as a necessary intervention, especially in systems that lack alternatives.

The research, conducted in Athens, Greece, examines how structural limitations, trust in psychiatry, and persistent stigma influence provider attitudes toward compulsory care, highlighting a disparity between professional ideals and entrenched practices.

“The findings demonstrate that mental health providers display complex, if not ambivalent, attitudes towards involuntary admissions,” the authors write. “On the one hand, they consider it beneficial for the patient and to exert a positive impact on the course of illness; hence, acceptance of the measure. On the other hand, most of the respondents have a clear community mental health care orientation, as they opt for people with SMI to be treated in the community. Moreover, they agree with the view that compulsory admission should be the last therapeutic resort… Therefore, for the majority of professionals, compulsory admission is a necessary evil.”

The study, led by Lily Evangelia Peppou of Panteion University of Social & Political Sciences, utilized an ecological framework to examine provider attitudes across multiple levels. At the macro level, researchers considered legal and social factors, including public stigma and national mental health laws. At the meso level, they assessed how the availability and structure of services shaped clinical decision-making. And at the micro level, they explored individual provider beliefs, demographics, and the dynamics of their working environments.