Human Rights of Persons With Mental Illness After the Korean Mental Health Act Revision: A Qualitative Study

Abstract

After the Constitutional Court of Korea ruled that the provision of involuntary admissions was unconstitutional, as it violates personal freedom, the Mental Health and Welfare Act was amended in 2016. The current study explores involuntary admission and discharge experiences, after the law's revision, from a patient-centered perspective and suggests future directions to protect human rights. Data were collected from seven persons with mental illness and three family members through in-depth individual interviews and analyzed using thematic analysis. Persons with mental illness were still not guaranteed full autonomy and the right to receive proper treatment due to lack of mental health resources. The burden on family caregivers was amplified by stricter admission requirements. These results indicate the need for human rights–friendly emergency services, including peer crisis shelters and procedural assistance services. The government should develop community-based mental health services to ensure continuity of care without imposing public responsibility on family members. [ Journal of Psychosocial Nursing and Mental Health Services, 60 (8), 27–35.]

A qualitative meta-synthesis of service users’ and carers’ experiences of assessment and involuntary hospital admissions under mental health legislations: a five-year update

“…Involuntary assessments and admissions were reported (35, 36, 37, 38, 39, 40, 41, 42) to be met on occasions with acceptance where this involved accessing support and a safe environment. At the same time, the impact of detention (32, 33, 35, 36, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53), or more specifically the impact of coercive treatment was presented (34, 37, 41, 42, 44, 48, 50) as a typically negative, traumatic experience for many. Feelings following discharge appeared to be mixed, with reported difficulties with coping in the community and managing mental health post-discharge (33, 37, 39, 41, 47, 48, 49, 51).…”

“…Dump you in the room to be stared at like some sort of strange animal.' (51) The detention process was seen (32,33,34,35,39,40,41,42,44,45,47,48,51,53,55) as contributing to stigma, for example through being perceived less credible or as dangerous by others (e.g. in daily life, or staff on the ward) due to having a mental health condition, or being seen to be taken and/or handcuffed by police.…”

“…(35) 7 Pathway to admission This theme reflects service users' experiences of the care pathway leading to assessment or involuntary treatment. It includes instances when primary studies reported experiences that admission was unnecessary or avoidable, and whether alternatives were available and explored, or to the contrary, when compulsory admission occurred because a lack of care in the community (34,35,39,40,41,48,53). As seen below, some studies reported a lack of access or availability of services that would be less restrictive than hospital admissions, whilst other papers reflected on experiences in which not receiving the right support (e.g.…”

“…(34) Carers Overview of included studies We included eight papers with carer participants. However, the following carer results are largely derived from six studies: three that interviewed carers only (56,57,58) and three with mixed samples of carers, service users and other stakeholders, who were interviewed or in focus groups (41,45,53). Two studies with mixed samples (35,51), both about experiences of detention with police powers and/or accessing police place of safety in England, included only one or no reference to carers in their results.…”

“…'family members often want the patient to be readmitted or taken to another mental health care facility, rather than living together.' (41) Carers in Connecticut and Ireland spoke of their desire for crisis planning and advance directives to prepare for possible future readmissions (57). Impact of coercion.…”