The term ‘mental health crisis’ is a widely used concept in clinical practice and research, appearing prominently in mental health literature across healthcare and social science disciplines. Within these contexts, the term is frequently either left undefined or defined rather narrowly, confined to clinical observations or guidelines targeted at healthcare providers and negating the multifaceted nature of crisis as described by those with lived experience. Therefore, the aim of this paper is to explore the characteristics of and provide a conceptual definition for the concept of ‘mental health crisis’. Rodgers' method of evolutionary concept analysis was employed and 34 articles, ranging from 1994 to 2021 and a variety of disciplines, were analysed. The results highlighted the contrast between clinically oriented surrogate terms and related concepts and those used by individuals with lived crisis experience. Antecedents of crisis included underlying vulnerabilities, relational dysfunction, collapse of life structure and struggles with activities of daily living. The concept's attributes encompassed the temporality of crisis, signs and symptoms of crisis, functional decline and crisis in family and caregivers. Finally, the consequences comprised looking inward for help, looking outward for help, and opportunities and dangers. This concept analysis serves as a foundational step in understanding ‘mental health crisis’ and its various dimensions, facilitating more nuanced discussions and interventions in the realm of mental healthcare.

Background: The World Health Organization describes the perpetuation of human rights violations against people with mental health problems as a global emergency. Despite this observation, recent studies suggest that coercive measures, such as seclusion, restraints, involuntary hospitalization, or involuntary treatment, are steadily or increasingly being used without proof of their effectiveness. In nursing, several literature reviews have focused on understanding nurses’ perspectives on the use of seclusion and restraints. Although many studies describe the ethical dilemmas faced by nurses in this context, to this date, their perspectives on patient’s rights when a broad variety of coercive measures are used are not well understood. The aim of this review is to produce a qualitative synthesis of how human rights are actually integrated into psychiatric and mental health nursing practice in the context of coercive work.Methods: Noblit and Hare’s meta-ethnographic approach will be used to conduct this systematic review. The search will be conducted in CINAHL, Medline, PsycINFO, ERIC, and Scopus databases, using the PICo model (Population, phenomenon of Interest, Context) and a combination of keywords and descriptors. It will be complemented by a manual search of non-indexed articles, gray literature, and other applicable data sources, such as human rights related documents. Qualitative and mixed-method study designs will be included in this review. Empirical and peer-reviewed articles published between 2008 and 2019 will be selected. Articles will be evaluated independently by two reviewers to determine their inclusion against eligibility criteria. The quality of the selected papers will then be independently evaluated by two reviewers, using the Joanna Briggs Institute’s Checklist for Qualitative Research. Data extraction and content analysis will focus on first- and second-order constructs, that is, the extraction of research participants’ narratives and their interpretation.Discussion: This review will provide a synthesis of how psychiatric and mental health nurses integrate human rights principles into their practice, as well as it will identify research gaps in this area. The results of this review will then provide qualitative evidence to better understand how nurses can contribute to the recognition, protection, and advocate for human rights in a psychiatric context.Systematic review registration: PROSPERO,CRD42019116862

Contexte : la dernière décennie témoigne d’un usage régulier ou croissant de la coercition en santé mentale et de la multiplication de ses formes. L’application de ces mesures s’appuie très souvent sur le travail du personnel infirmier, mais peu d’études ont analysé les enjeux aux droits humains soulevés par ces pratiques. Objectif : l’objectif général de cette recherche est de produire une synthèse qualitative de la manière dont les droits humains sont intégrés dans la pratique du personnel infirmier faisant usage de coercition en santé mentale. Méthodologie : une recension systématique des écrits scientifiques employant un devis qualitatif publiés entre 2008 et 2018 a été réalisée et complétée par une analyse méta-ethnographique. Résultats : l’analyse des 46 études retenues a fait ressortir quatre thématiques distinctes : la coercition en santé mentale comme objet sociojuridique, les enjeux de reconnaissance des droits humains en santé mentale, le conflit de rôle vécu par le personnel infirmier, la signification de la coercition comme mal nécessaire ou comme incident critique. Discussion et conclusion : des efforts de recherche supplémentaires doivent être consacrés à comprendre les particularités du continuum de soutien et de contrôle caractérisant le travail coercitif du personnel infirmier en psychiatrie.

Background/Objectives: Perceived coercion has been associated with significant negative outcomes, including service avoidance and psychological distress. Despite growing interest, no recent comprehensive review has mapped the full range of factors influencing this experience. This scoping review aimed to synthesize and present the state of knowledge on the factors associated with perceived coercion by adults receiving psychiatric care. Methods: Following the Joanna Briggs Institute methodology, a systematic search of five databases and grey literature was conducted for publications from 1990 to 2025 in English and French. A total of 143 sources were included and thematically analyzed. Consultation with experts and individuals with lived experience enriched the interpretation of findings. Results: Five categories of factors were identified: individual, clinical, relational, legal, and structural. Relational and legal factors were most consistently associated with perceived coercion, while individual and clinical factors showed inconsistent findings. Structural influences were underexamined but significantly shaped the experiences of the individuals receiving care. Conclusions: Perceived coercion arises from a complex dynamic of individual, relational, and systemic influences. Reducing coercion requires moving beyond individual-level factors to address structural conditions and policy frameworks. Future research should prioritize qualitative and intersectional approaches and amplify the voices of those most affected by coercive practices in psychiatric care.

A growing body of literature highlights the involvement of nurses in the application of involuntary commitment and treatments in psychiatry. The violence underlying these coercive practices is often discussed, as they infringe on human rights and have negative effects on both patients and healthcare staff. The current state of knowledge on this subject, however, fails to inform us of what characterizes and influences these practices in psychiatric nursing. A situational analysis was conducted to gain a better understanding of this issue. This qualitative research aims to explore the characteristics of nursing care during involuntary commitment and treatments. In all, 10 nurses ( n = 10) and 11 patients ( n = 11) participated in semi-structured interviews and completed a sociodemographic questionnaire. Data analysis followed a grounded theory approach, involving a process of coding, conceptualizing, categorizing, constant comparison, and relational mapping, accompanied by analytical memos. Four conceptual categories emerged from data analysis: (1) Psychiatry as a waiting room, (2) nurses as subordinates, (3) nothing else but medication, and (4) resisting undignifying care. The results suggest that clinical issues surrounding involuntary commitment and treatments can be explained by how care is conceived. The psychiatric nursing practice seems to be limited to the application of coercive power, such as forced administration of medication. The distress potentially induced by involuntary commitment and treatments in patients comes to be ignored in favor of compliance with the legal procedures. The results describe a situation where patients felt abandoned to those procedures as if refusing to be hospitalized or treated were incompatible with any other form of care. Several participants also report having suffered negative consequences following one or more coerced psychiatric episodes. For them, refusal of care therefore seems to be associated with a resistance against the current violence of biomedical psychiatry, rather than a refusal to obtain help and support.