Abstract
Based on the UN Convention on the Rights of Persons with Disabilities (CRPD), several UN bodies, among them the High Commissioner for Human Rights, have argued for a complete ban of all coercive interventions in mental health care. The authors conceptualize a system for mental health care based on support only. Psychiatry loses its function as an agent of social control and follows the will and preferences of those who require support. The authors draw up scenarios for dealing with risk, inpatient care, police custody, and mental illness in prison. With such a shift, mental health services could earn the trust of service users and thereby improve treatment outcomes.
Highlights
Based on the UN Convention on the Rights of Persons with Disabilities (CRPD)(United Nations 2018a), several UN bodies, among them the High Commissioner for Human Rights, have argued for a complete ban of all coercive interventions in mental health care (United Nations 2013, 2014, 2017a, 2017b, 2018b)
Psychiatry loses its function as an agent of social control and follows the will and preferences of those who require support
We argue that lending more weight to a “person’s deep beliefs, values, or personal conception of the good”, and thereby disregarding the actual will of a person in relation to a given situation, risks ignoring the discontinuities in their personal development and thereby interfere with legal capacity
Summary
(United Nations 2018a), several UN bodies, among them the High Commissioner for Human Rights, have argued for a complete ban of all coercive interventions in mental health care (United Nations 2013, 2014, 2017a, 2017b, 2018b). This report supports the abolition of all involuntary treatment and the adoption of measures to ensure that health services including all mental health services are based on the free and informed consent of the person concerned, as stipulated by the UN Committee on the Rights of Persons with Disabilities and “the elimination of the use of seclusion and restraints, both physical and pharmacological.” (United Nations 2017a). All these postulations, are in stark contrast with the reality of mental health care. We will argue that mental health care without coercion will comply with human rights standards, but will improve care and treatment outcomes for the most vulnerable if a number of safeguards are introduced
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