“They Don’t Know About Suffering”: Reasons from Physicians and Users for the Use of Coercion After a Suicide Attempt in Latin America

Abstract

The use of coercive practices worsens recovery processes in mental health. These practices have various forms of presentation that must be identified to incorporate a rights-based approach into care processes. The aim was to describe and analyze the reasons perceived by physicians who employed coercive practices and by the individuals on whom these practices were employed, following a suicide attempt in Caldas, Colombia, in 2023 and 2024. A qualitative, transversal, and descriptive research design was used. Data collection was conducted in two phases: in-depth interviews with individuals who had attempted suicide were carried out between January and December 2024, and interviews with healthcare professionals were conducted between November 2024 and January 2025. A total of 30 participants were included, all of whom had attempted suicide and for whom coercive measures had been taken at a clinical level. In addition, 22 medical professionals who treated one of the 30 participants during their suicide attempt were included. Through content analysis, the interviews were divided into two themes. The first, based on interviews with individuals who had attempted suicide, was titled Reasons perceived by people using health services after a suicide attempt and comprised three categories: Lack of knowledge, Lack of willingness to help, and Obligation. The second theme, Reasons perceived by medical professionals, comprised categories such as Coercion as a primary resource, Coercion in medical training, and Coercion as medical protocol. Coercive measures, even though they are protocolled by health professionals, cause great suffering and hinder the recovery of people who have experienced coercive practices in mental health.