Human rights and the use of psychiatric medication

Abstract

Purpose – Formal recognition of the human rights of people living with mental health problems has greatly progressed. We must ask ourselves, however, to what extent the formal recognition of these rights has transformed the culture of psychiatric care and improved their quality of life. Gaining Autonomy & Medication Management (GAM) is an approach that strives to empower service users and providers and promotes the exercise of users’ rights by transforming their relationship with the central component of psychiatric treatment in community services: psychopharmacology. The purpose of this paper is to show how GAM highlights the issues surrounding the establishment of a culture of rights. Design/methodology/approach – For this analysis qualitative data were collected in Brazil and in Quebec, Canada, through over 100 interviews done with people living with mental health issues and practitioners who participated in the different GAM implementation projects. Findings – Issues, challenges and obstacles facing the instauration of a human rights culture in mental health services are presented. The profound changes that the understanding and exercise of users’ rights bring to the lives of individuals are supported by excerpts illustrating recurring issues, situations and common experiences that appear in the various contexts of the two different countries. Research limitations/implications – This is not a parallel study taking place into two countries. The methodologies used were different, and as a consequence the comparative power can be limited. However, the results reveal striking similarities. Originality/value – There is scant research on human rights in mental health services in the community, and the issues surrounding the prescribing and follow-up of pharmacological treatment. The joint analysis of the researches in Brazil and in Canada, identified common challenges which are intertwined with the dominant approach of biomedical psychiatry.

Autonomous medication management group in a psychosocial care center: participants’ experience

“…(P6, January 2017) GAM understands that users have the right to information and with it they can adapt the treatment to their needs and, thus, they use the guide as a tool that provides information about medication and encourages them to reflect upon the treatment and related issues. In this respect, they will hopefully seek to know about and make decisions according to their needs and wishes relating to medication together with health professionals who assist them in a shared care building process (Onocko Campos et al, 2014). The GAM-BR guide is comprised of two parts and six steps with various questions.…”

“…Furthermore, even with the advancing arrangements in mental health, we note that pharmacological treatment is dominant in the actions of mental health professionals, to such an extent that, sometimes, mental health treatment is limited only to psychotropic substances. Barrio et al (2014) emphasize that medicalization remains an unreformed practice not only in Brazil but also in other developed countries. Hospitalization and prescription renewal without the in-person assessment of users are still common responses to the demands of the health care system.…”

“…Also, the more connected users, family, and healthcare team are to a care network, more possible ways of proper medication administration and management there are. Through dialogue between users and professionals, it is possible to assess how the use of medication is improving quality of life, reducing the suffering caused by disease symptoms, or, in contrast, increasing it with unwanted effects (Onocko Campos et al, 2014). In this respect, the mental health groups contribute to the rehabilitation of the suffering individuals, to their self-care, and can help them to deal with the experienced issues, such as daily social life, functions, and practices, hindered by a suffering background (Ribeiro, Marin, & Silva, 2014).…”

'¿Qué hago? ¿Me recomiendan algo?' Comunidades virtuales y agorafobia, un espacio para la participación compartida en la gestión de la medicación

“…Como señalan Rodríguez, Onocko, Stefanello et al (2014), en los últimos años han surgido varios modelos que proponen prácticas que brindan un espacio significativo para el diálogo y la toma de decisiones compartida entre el/la usuario/a y su médico prescriptor/a. Lo que destacan los autores en estos modelos es el cambio que plantean en la consideración del tratamiento farmacológico, las prácticas de prescripción y la relación entre los/las profesionales sanitarios/as y los/ las usuarios/as.…”

O Comitê Cidadão e o trajeto participativo da pesquisa GAM

“…(Rodriguez et al, 2006;Rodriguez et al, 2008 (Dimov, 2016, Moltu, Stefansen, Svisdahl & Veseth, 2013, Presotto, Silveira, Delgado & Vasconcelos, 2013, Russo, 2012 Rev. Polis e Psique, 2020; 10(2): 9 -32. processos de tomada de decisão e construção de ação (Rodriguez Del Barrio & Poirel, 2007, Rodriguez Del Barrio et al, 2014 (Latour, 1996(Latour, , 1999(Latour, , 2003(Latour, , 2005 (Campos et al, 2012, Emerich, Onocko & Passos, 2014, Gonçalves & Campos, 2017, Gonçalves, 2013, Passos et al, 2013ª, Presotto et al, 2013, Presotto, 2013, Silveira, 2013, de Carvalho Otanari et al, 2011 (Gonçalves, 2013, Passos et al, 2013a. (Dimov, 2016, Silveira, 2013, Zambillo, 2015.…”