Use of coercive measures in refugees and asylum seekers: a systematic review

Abstract

Migration process is a well-known risk factor for a number of mental disorders, particularly psychotic, trauma-related and major mood disorders. However, refugees and asylum seekers (RAS) often face several challenges in accessing mental health facilities, leading to treatment delays, resulting in worse prognosis and increased risk of referral to the emergency departments or receiving coercive measures, including involuntary hospitalizations in the psychiatric settings. This review aims to delineate the prevalence of coercive measures within the RAS population and identify potential predictors for such interventions, in order to highlight possible preventive strategies. The relevant PubMed, Scopus and Web of Science databases were searched for papers. Twenty-three articles were included in the review. Our findings highlight that the RAS population is at higher risk of being coerced compared to the native population due to clinical factors, cultural differences and the many barriers to the access to mental health services. Since coercive measures are often harmful and lead to a worse clinical outcome and possible (re)traumatization of patients, specific strategies to prevent this phenomenon are urgently needed.