Abstract
SummaryThe Royal College of Psychiatrists has established a Working Group on Choice in Mental Health and held a conference to include service users in formulating a challenging view of the choice agenda for mental health. This is set out here to stimulate wider interest. Choice-based practice develops in a climate of trust and information, and goes beyond simple variety or individual consumerism. For some service users, limited initial areas of choice can be of great importance, but a true culture of choice requires the widespread participation of service users and carers in service improvement. It is important that psychiatrists champion the empowerment of their patients through choice, in policy and training, and in clinical practice.
Highlights
Treatment options other than hospital admission are available to service users, for instance crisis resolution and home treatment[8] and crisis houses,[9] patients must not be unreasonably deprived of the choice of hospital admission where this is the safest and most effective place of treatment and when it is preferred by the patient and carer
Choice and participation must be central to future policy of the Royal College of Psychiatrists
A meta-analysis of over a hundred outcome studies in schizophrenia conducted in high-income countries throughout the 20th century[4] assessed whether individuals had achieved ‘social recovery’ (economic and residential independence and low social disruption) or ‘complete recovery’
Summary
Choice can be defined as the selection of one or more options among a variety available, and in healthcare this can be seen as a guarantor of patient autonomy and dignity. The notion of choice bringing power and control to patients as customers is an attractive one. It is important that choice in areas such as mental health is not equated with health consumerism and competition, but rather emphasises collaboration between service users and service providers and service user empowerment.[1]. Enabling choice for patients and their carers (even when they may disagree with each other) allows them to take more responsibility for the patient’s care and to enjoy truly open relationships with treating doctors and other healthcare professionals. Choice, as part of an honest participative relationship with the patient, is key to the development of professionalism in mental healthcare.[2]
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