Alternatives to coercion in mental health care: <scp>WPA</scp> Position Statement and Call to Action

Herrman, Helen; Allan, John; Galderisi, Silvana; Javed, Afzal; Rodrigues, Maria de Lourdes Veronese

doi:10.1002/wps.20950

Cited by 36 publications

(29 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There is also a developing literature on the need for states to promote good mental health through appropriate allocation of resources and related 'positive' human rights. 26,27 The main point of consensus is that coercion in mental healthcare can and should be reduced 1,9,10,28 and the range of voluntary options for support be expanded. [29][30][31][32]…”

Section: Resultsmentioning

confidence: 99%

“…The World Psychiatric Association's (WPA's) 2022 position statement 1 calls for action to support the implementation of alternatives to coercion in mental healthcare and emphasises that the protection of human rights is a central concern. The statement reflects recent advances in international human rights law associated with the coming into force of the United Nations Convention on the Rights of Persons with Disabilities 2 (CRPD).…”

mentioning

confidence: 99%

See 1 more Smart Citation

Human rights promotion and the ‘Geneva impasse’ in mental healthcare: scoping review

2023

View full text Add to dashboard Cite

Background The World Psychiatric Association recently emphasised that the protection of human rights in mental healthcare was a ‘central concern’. This paper examines recent literature on human rights and mental healthcare. Aims To (a) outline how international human rights law distinguishes between the protection and promotion of human rights; and (b) explore the literature on promoting human rights in mental healthcare which avoids what has been termed the ‘Geneva impasse’ between those who argue that compulsory care and treatment can never comply with human rights law and those who argue that they can if certain conditions are met. Method The following doctrinal methodology was used: (a) identification and detailed analysis of international human rights conventions and commentaries; (b) identification of key literature on human rights and mental healthcare; and (c) critical analysis of key issues emerging from the literature. Results Much of the literature on human rights and mental healthcare focuses on whether restrictions on compulsory care are required to meet the requirements of United Nations Conventions. There is an emerging literature identifying measures to promote the right to the enjoyment of the highest attainable standard of mental health. Conclusions There has been a focus on protecting the rights to liberty and equality before the law for mental health patients. The nascent literature on promoting human rights in mental healthcare could mark a way forward beyond the ‘Geneva impasse’ that has dominated public debate in recent years.

show abstract

Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

Human rights promotion and the ‘Geneva impasse’ in mental healthcare: scoping review

2023

View full text Add to dashboard Cite

show abstract

“…Although there are a range of efforts to implement alternatives to seclusion ( 13 ), we suggest new models of care must be able to effectively manage aggressive and sometimes violent behavior known to be signs of some clinical conditions ( 27 ). The present paper suggests that contemporary models of care in inpatient mental health units may not yet provide satisfactory management solutions for some admitted people, even though alternative strategies have been reported to have a “ reasonably high degree of evidence for effectively reducing the use of coercive measures in clinical practice ” ( 9 ).…”

Section: Discussionmentioning

confidence: 96%

“…Further complicating matters, in Aotearoa as elsewhere, a paradigm shift toward a human rights-based framework has challenged more traditional models of compulsory inpatient care, as has our increasing awareness of the negative impact of trauma and coercive models of compulsory care, seclusion, and restraint ( 9 ). Government policy now encourages the elimination of seclusion and restraint.…”

Section: Introductionmentioning

confidence: 99%

Imprisonment following discharge from mental health units: A developing trend in New Zealand

et al. 2023

View full text Add to dashboard Cite

IntroductionContemporary models of care for people with mental disorders continue to shift to community-based care, requiring fewer inpatient mental health beds, shorter inpatient lengths of stay, and less use of coercion. It has been suggested that some mentally unwell people, whose behavior can no longer be safely contained in overstretched mental health units where seclusion and restraint are discouraged, are now left to the criminal justice system to manage. It is unclear whether the risk of imprisonment following discharge from a mental health unit has increased over recent years.MethodsA quantitative, retrospective cohort study design was used to investigate any association between an acute inpatient mental health service admission in Aotearoa (New Zealand), and referral to a prison mental health team within 28 days of hospital discharge, from 2012 to 2020. Data were extracted from the national mental health dataset managed by the Ministry of Health.ResultsRisk of imprisonment within 28 days of inpatient discharge increased over the study period. People experiencing this outcome were more likely to be younger, male, of Mâori or Pacific ethnicity, presenting with substance use and psychotic disorders who were aggressive or overactive, and were subject to coercive interventions such as seclusion and compulsory treatment during their admission.DiscussionWe concluded that contemporary models of less coercive predominantly community based mental health care may be increasingly reliant on the criminal justice system to manage aggressive and violent behavior driven by mental illness. It is argued from a human rights perspective that mental health inpatient units should retain the capacity to safely manage this type of clinical presentation.

show abstract

“…Recently, the World Psychiatric Association adopted a position statement concerning the protection of people living with mental disorders or disabilities and released a call to action within the community to ensure alternatives to coercion [25]. Researchers around the world have been studying various effective means of reducing the use of seclusion and restraint.…”

Section: Introductionmentioning

confidence: 99%

Seclusion and mechanical restraint in the wake of the COVID-19 pandemic: an increased use in mental health settings

Goulet

Cassivi

Hupé

et al. 2023

Preprint

View full text Add to dashboard Cite

Purpose: COVID-19 pandemic-related restrictions have significantly changed the environment and the delivery of direct care in all health services, including psychiatric hospitals. The aim of the study is two-fold: 1) to retrospectively assess the prevalence of seclusion and mechanical restraint in a Quebec mental health hospital over 4 years; and 2) to assess the impact of the COVID-19 pandemic on their prevalence. Methods: We conducted a retrospective study based on medical records from a Quebec mental health hospital collected (a) from April 2016 to March 2019), (b) from April 2019, to March 2020 (pre-COVID onset), and (c) from April 2020 to March 2021 (post-COVID onset). Descriptive statistics, chi square tests, Mann-Kendall test and Welch's t-test were performed. Results: Following several years during which the use of restrictive measures remained stable, we have noted a significant increase within the first year following the COVID-19 pandemic. This increase can be seen in the use of both seclusion and restraints, which have risen 205% and 170% respectively. Conclusion: There are a multitude of factors associated with the prevalence of seclusion and restraint that have the potential to be triggered during emergencies and global crisis situations, impacting in turn the rights of an already vulnerable population.

show abstract

Alternatives to coercion in mental health care: WPA Position Statement and Call to Action

Cited by 36 publications

References 10 publications

Human rights promotion and the ‘Geneva impasse’ in mental healthcare: scoping review

Human rights promotion and the ‘Geneva impasse’ in mental healthcare: scoping review

Imprisonment following discharge from mental health units: A developing trend in New Zealand

Seclusion and mechanical restraint in the wake of the COVID-19 pandemic: an increased use in mental health settings

Contact Info

Product

Resources

About