Trauma- or coercion-related refusal

History of retraumatising care, forced treatment, institutional mistrust

RoutineReview due

Compare (7)

At a glance

High-risk causes: 3
Related differentials: 6

Safety snapshot

Watch forEscalation with coercive approachdissociationself-harm

Presentation hinge

Altered reality testing drives refusal rather than simple preference.

Separates the Treatment Refusal / Non-Adherence / Poor Insight group. It is not specific to Trauma- or coercion-related refusal.

Clinical review

Rows marked “Whole group”: Applies to the Treatment Refusal / Non-Adherence / Poor Insight group — not specific to Trauma- or coercion-related refusal

Why it fits

History of retraumatising care, forced treatment, institutional mistrust

Key features

Must-not-miss

Escalation with coercive approach, dissociation, self-harm.

High-risk causes3 causes

Escalation with coercive approach
dissociation
self-harm

Bedside question

Applies to the Treatment Refusal / Non-Adherence / Poor Insight group.

Altered reality testing drives refusal rather than simple preference.

Helpful clues

Immediate action

Applies to the Treatment Refusal / Non-Adherence / Poor Insight group.

None listed

Priority steps

Investigations

Applies to the Treatment Refusal / Non-Adherence / Poor Insight group.

None listed

Core tests

Mimics / overlap

Applies to the Treatment Refusal / Non-Adherence / Poor Insight group.

None listed

Consider

Clinical reference — not validated decision support. Review before use.