Overview of Themes and Sub-Themes.

This study, co-produced by a team of academics, lived experience researchers and clinicians, explores the views and experiences of people who have been compulsorily detained in hospital under the Mental Health Act (1983) (MHA) in England, to understand how and why, from their perspective, compulsory detentions occur, and what might help prevent them. Semi-structured qualitative interviews were conducted with 20 people (55% male, 40% Black/Black British, 30% White British) who had been compulsory detained in hospital within the past 5 years. Lived experience researchers with relevant personal experience carried out interviews via telephone or videoconference and participated in analysis of data via a template approach. We derived three over-arching themes from interviews. The first theme “Individual factors increasing or reducing likelihood of being detained” encompassed factors related to people’s own lives and attitudes, including life stressors, not taking medication as prescribed, the risk individuals may pose to themselves or others, and their attitude to and management of their mental health. The second theme “Family and Social Network” reflects how attitudes and quality of support from family, friends and social network may contribute to compulsory detentions or help people to stay well. The third theme “Need for improvement in Service Responses” identified limitations of services that contribute to detention, including lack of collaborative care and choice, poor quality of professional support, and discriminatory attitudes from staff. Each theme also included potential approaches to addressing these limitations and reducing compulsory detentions. Findings suggest multiple interacting factors may lead to people being detained in hospital under the MHA, and that improvements to services, such as increasing collaborative care and service user-led family involvement, could prevent further detentions.

本研究由学者、亲身经历研究者与临床医师团队联合开展，聚焦英格兰地区依据《1983年精神健康法案》（Mental Health Act 1983，MHA）被强制收治入院的群体的观点与经历，旨在从受访者视角探究强制收治的发生逻辑与成因，以及可用于预防此类情况的可行路径。研究对近5年内曾被强制收治入院的20名受访者开展半结构化质性访谈，其中男性占比55%，黑人/非裔英国籍占40%，英国白人占30%。拥有相关个人经历的亲身经历研究者通过电话或视频会议完成访谈，并采用模板分析法参与数据编码与分析工作。研究从访谈资料中提炼出三大核心主题：其一为"影响收治风险的个体因素"，涵盖与受访者自身生活及态度相关的各类要素，包括生活应激事件、未按医嘱服药、个体对自身或他人构成的风险，以及受访者对自身精神健康的态度与管理方式；其二为"家庭与社会支持网络"，该主题探讨家庭、朋友及社会网络的支持质量与态度，如何既可能促成强制收治，也能帮助个体维持精神健康状态；其三为"服务响应亟待改进"，该主题明确了与强制收治相关的服务局限，包括缺乏协作式诊疗与选择权、专业支持质量低下，以及工作人员存在歧视性态度。每个主题同时包含了针对上述局限的潜在解决路径，以及减少强制收治的可行措施。研究结果显示，多种交互作用的因素可能导致个体依据《精神健康法案》被强制收治；而优化服务体系——例如强化协作式诊疗、推动服务使用者主导的家庭参与等举措——或可预防后续的强制收治行为。