Involuntary Detention and Treatment: Are We Edging Toward a “Paradigm Shift”?

Abstract

Recent challenges to conventional mental health laws concerning involuntary detention and treatment of persons with a mental disorder have led to proposals, or indeed an insistence, that fundamental reform is necessary. A key theme has been the need to eliminate unfair discrimination against people with a mental disorder because their human rights are not respected on an equal basis with other people. Some proposals depart radically from conventional assumptions concerning the justification of involuntary detention and treatment. One is a “fusion law,” a generic law applying to all persons lacking the ability to make a treatment decision, whether resulting from a “mental” or “physical” illness. An authoritative interpretation of the UN Convention on the Rights of Persons with Disabilities (2006) goes so far as to maintain that involuntary interventions are a violation of the Convention.

Mental Health First Aid Training: A Study of Community Members’ Pre and Post-training Responses to a 17-Item Questionnaire

“…According to this study, community members' responses improved, mild to significant levels, after MHFA training and substantiated the findings of other researches; evidently patients with mental disorders do not get proper medical care [34][35][36]; exercise helps improvement of mild to moderate anxiety and depression [67][68][69]83]; MH workers should encourage rather than force a patient with mental disorders to seek help in mental health settings [1,[43][44][45][46]; many mental disorders including anxiety disorders, depression and also other disorders improve with non-drug therapies including CBT [39][40][41][52][53][54][55], and remit with antidepressants and anxiolytics [1,50,51]; anxiety and panic disorders do not cause medical diseases but often present with symptoms micking medical diseases [58,59]; strong approval or disapproval of patients aggressive behaviors due to culturally unacceptable lifestyles is against prevailing norms and human rights, and of course prejudiced and stigmatized [1,[43][44][45][46]; exploring non-judgmentally suicidal behavior including indicators of suicide does not increase the risk of suicide rather prevent it [28,[31][32][33][60][61][62]83,84]; immediate discussion and debriefing individuals with acute psychosis due to acute trauma or othe...…”

“…Mental health experts must deal non-reactively with patients entertaining persecutory delusions and accusations directed towards others people [1,[43][44][45][46]. The trainees correct (A, 17S) and wrong (D) responses increased insignificantly (>0.05) and DNK responses decreased insignificantly (>0.05) post-test evaluation.…”

Supported Decision-Making and Paradigm Shifts: Word Play or Real Change?

“…Arguments also exist that capacity-based mental health laws not only guarantee beneficial treatment where required and safety but also ensure parity of esteem in terms of treatment of persons with physical and mental health conditions ( 8 – 11 ). This viewpoint appears to be relatively popular given that several states in recently reforming their mental health and capacity laws have either retained, or introduced, capacity or capacity-type thresholds for non-consensual interventions ( 12 ) [for example, Victoria's (Australia) Mental Health Act 2014 and the Mental Capacity Act (Northern Ireland) 2016].…”

Akzeptanz von psychiatrischen und somatischen Patientenverfügungen: ein Vergleich unter psychiatrischen Patienten und Fachpersonen

“…Urteilsfähig im Sinne des Gesetzes ist, wer die Fähigkeit zu vernunftgemäßem Handeln hat, eine (Krankheits-)Situation realistisch erfasst, Informationen dazu versteht, mögliche Handlungsweisen und deren Konsequenzen einschätzen und werten kann (Wissens-und Einsichtsfähigkeit) sowie eine Wahl treffen, diese äußern und gemäß dieser Wahl handeln kann (Willens-und Steuerungsfähigkeit) [3][4][5].…”