Voluntary and involuntary mental health service users' views on how their human rights were considered

Abstract

Background: The legal framework for governing involuntary treatment in England and Wales is set out in the Mental Health Act (1983) which gives health professionals power, in certain circumstances, to detain, assess and treat people considered to have a ‘mental disorder’, in the interest of their own health and safety or for public safety. It is accompanied by a Code of Practice and other statutory safeguards that aim to preserve service users’ human rights. While some people find psychiatric inpatient treatment helpful and necessary, there are growing concerns that services are failing to protect service users’ human rights. Aims: To deepen an understanding of how service users’ human rights are respected on psychiatric inpatient wards. Key research questions were: what are voluntary and involuntary inpatient service users’ experiences of staff respecting their human rights; what are voluntary and involuntary inpatient service users’ experiences of being informed about their rights; and what impact do these experiences have on voluntary and involuntary service users? Method: A mixed methods approach used. Semi-structured interviews with twelve service users with experience of psychiatric inpatient treatment in England were carried out. In addition, a brief 10-item questionnaire was completed at the end of each interview. Interviews were transcribed and analysed using thematic analysis. Data from questionnaires were analysed using descriptive statistics. Findings: Five themes were generated to describe participants’ experiences: Deprived of Rights; Rights Upheld, Emotional Impact; Battle for Rights; and Information about Rights. Participants’ raised a number of concerns with regards to how their human rights were respected. Their accounts were characterised by restrictions on liberty and autonomy, a lack of privacy dignity and respect, and issues relating to equality and discrimination. Concerns were also raised regarding the provision of information about their legal rights. Implication: Interventions across multiple levels are required to promote a human rights-based approach. Organisational policies and practices must be scrutinised; staff must be made aware of how human rights apply to their work and offered regular support to cope with the emotional demands of the role; and a review of government policy is needed to examine structural factors that both inhibit and promote change.