COERCIVE INTERACTIONS IN A PSYCHIATRIC EMERGENCY ROOM

This paper describes the prevalence of coercive and non-coercive efforts to influence patients' admission decisions in a psychiatric emergency room. The findings are based on previously collected transcripts of the interaction between patients and families and emergency room staff in 405 cases. Although a significant percentage of the patients were involuntarily admitted, otherwise the most prominent pressures were efforts by attending physicians to persuade patients about what would be the most appropriate disposition. However, a detailed qualitative analysis of the interaction suggest that the clinical staffs power to commit patients against their will affects the way all parties interpret the staffs ''persuasion'' in such a way that it may be understood as quite coercive.