Abstract
Supported Decision Making in the Prevention of Compulsory Interventions in Mental Health Care.
Highlights
Kliniken Landkreis Heidenheim gGmbH, Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Teaching Hospital of Ulm University, Heidenheim, Germany
International law and clinical practice shaped the emergence of supported decision making in mental health care: the UN Convention on the Rights of Persons with Disabilities, in particular Article 12 on Equal Recognition before the Law (1), the General Comment No.[1] of the UN Committee on the Rights of Persons with Disabilities (2) emphasizing “support in the exercise of legal capacity” and obliging states “to replace regimes of substitute decision-making by supported decision-making, which respects the person’s autonomy, will and preferences,” the introduction of shared decision making in medicine (3), and the users’ movement challenging traditional paternalistic approaches in psychiatry (4)
Some commentators went as far as suggesting “an urgent consideration with the full participation of practitioners” (6). Rather than extending this discussion, I will look at how supported decision making could work in the treatment of severe depression and psychosis, with the aim to prevent coercive interventions
Summary
International law and clinical practice shaped the emergence of supported decision making in mental health care: the UN Convention on the Rights of Persons with Disabilities, in particular Article 12 on Equal Recognition before the Law (1), the General Comment No.[1] of the UN Committee on the Rights of Persons with Disabilities (2) emphasizing “support in the exercise of legal capacity” and obliging states “to replace regimes of substitute decision-making by supported decision-making, which respects the person’s autonomy, will and preferences,” the introduction of shared decision making in medicine (3), and the users’ movement challenging traditional paternalistic approaches in psychiatry (4). Some commentators went as far as suggesting “an urgent consideration (of the General Comment No.1) with the full participation of practitioners” (6). Rather than extending this discussion, I will look at how supported decision making could work in the treatment of severe depression and psychosis, with the aim to prevent coercive interventions. With an emphasis on will and preferences, supported decision making should have some potential in reducing coercive interventions in mental health settings
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