The World Association of Social Psychiatry (WASP) is affiliated to the World Psychiatric Association (WPA) and the two bodies share many common goals. The WASP working party on coercion in mental health care recently released a set of guiding principles and standards in late 2015, developed from the research and collaboration of members alongside issues highlighted in the literature and raised by human rights groups. These principles are set out below and are designed to be applicable in all countries:
- All individuals in a community should have access to the most effective affordable mental health care that is available.
- All individuals have the right to receive that care in the least restrictive manner possible.
- Individuals have the right to determine their own needs and requirements for treatment as far as is possible.
- Where treatment is compelled, this must be done proportionately, humanely, and in accordance with the relevant international conventions.
- Countries must give mental health care parity with physical healthcare and allocate budgets and support accordingly.
- High Income Group countries must support those in need to develop and improve their mental health services as a global ‘civic duty’.
Article highlighting human rights issues in Uganda published
British journal of Psychiatry International has published an article from group members in conjunction with major international human rights charity MDAC on mental health care in Uganda. It highlights some of the challenges and looks at opportunities for change and better care going forwards. The link below will take you straight to it:
First international conference on crisis care and coercion 2018 Rotterdam
The first international conference on crisis care and coercion has been announced and will be taking place in Rotterdam, The Netherlands, in October 2018. There should be many relevant talks and symposia for people interested in acute mental health care and human rights.
Launch of a new European Society
The European Society of Social Psychiatry (ESSP) has recently been set up. The first congress of the ESSP, chaired by François Ferrero, was held last week in Geneva. The conference contained many sessions regarding coercion ad was a great success, fostering interest, partnerships, and collaborations which we hope we can build on. For the first time, such a congress contained specific workshops on the practical aspects of what might be done to reduce coercion in clinical practice. Feedback was excellent and we hope to run more workshops at future events. We will keep updating the site with such news.
Coercion In mental health care- International perspectives
Members of the group have worked over recent years with key academics, clinicians, and service users from around the world to create a book that takes a global perspective on the issue of coercion. There are chapters regarding the law, ethics, practical considerations, the effects of economy and culture and many more things. There is also a chapter from each continent identifying important regional issues for the first time in the literature.
WE NEED YOUR HELP!
Colleagues in The Netherlands are hoping to get the views of mental health workers in Sweden, England and the Netherlands on the use of community compulsion. Please see below for detail sand please do help if you can. Thanks!!!
Compulsory Treatment in the Community, if so, on what basis?
A research project investigating the opinion of healthcare workers on compulsory community treatment.
The Dutch government is designing new mental healthcare legislation. This new legislation will create the possibility for compulsory community treatment to be used in mental healthcare in the Netherlands. Compulsory treatment in the community as suggested in these bills is new in the Dutch healthcare system.
The Vincent van Gogh Institute for Psychiatry, a mental healthcare organisation in the South of the Netherlands, is performing a research project investigating the experience healthcare workers have with compulsory community treatment and what they think of it.
Goal and questions
We want to get an insight into the ethical and practical issues that health care professionals struggle with when working with issues around CCT. We would like to know if professionals from different countries would handle certain situations differently and what principles drive them when using coercion, focussing on core concepts like autonomy and duty of care. We aim to get consensus on what health care professionals in different countries think is important in regulations concerning CCT.
We will invite professionals from Sweden, England and the Netherlands to participate. Sweden and England already have possibilities for CCT in their legislation. We will use the outcomes of this research in a guideline we aim to write about the use of CCT.
Within this guideline, we will also include the opinions of service users and their relatives, who will be interviewed in a later stage of this project.
We will use the Delphi method to get an insight in what drives different health care professionals in the use of coercion and compulsory community treatment and what values and guidelines are important. We have designed three different vignettes and ask health care workers how they would approach these situations. We will ask them what makes them choose different solutions and what principles they keep in mind. The Delphi-method does not rely on statistical power, but literature recommends 10-18 people in one group (Okoli 2004). We will aim for 32 participants in each country. We will try to include 16 psychiatrists and 16 community nurses or social workers.
The first round of the Delphi study will involve questions on the vignettes, focussing on values and morals the drive the health care workers. The second round of the Delphi study will focus on the more practical issues, like what kind of guidelines or rules are necessary.
The third round will involve more in-depth questions based on conclusions drawn on the answers of the first two rounds.
After three rounds the answers will be analysed and compared. Comparisons will be made between different countries and between different professions.
We are looking for psychiatrists and community nurses or social workers who would like to share their opinion on CCT. Participation encompasses filling out three electronic questionnaires, each will take about 15 minutes, over the course of six months. Data will be collected and analysed anonymously.
Medical Research Ethics Committee of the Erasmus University of Rotterdam decided that this part of the study is not subject to the Medical Research Involving Human Subjects Act and does not need further ethical approval.
We have presented our project to a representative of the Regional Ethical review Board in Lund and it was concluded that we do not need additional ethical approval in Sweden. We also consulted the NHS Health Research Authority and it was concluded that this research does not need NHS REC approval for research in England.
Further information and participation
All the information about the research can be found on our website: http://www.studyintocct.com
On this website you can also fill out the contact form if you would like more specific information or if you are interested in participating.
You can also contact us directly by email: email@example.com
We are looking forward to hearing from you and we hope you are interested in participating,
D. de Waardt, psychiatrist at Vincent van Gogh, for mental health, Venlo, The Netherlands
F. van der Heijden, psychiatrist at Vincent van Gogh, for mental health, Venlo, The Netherlands
Prof. C.L. Mulder, psychiatrist at Erasmus University of Rotterdam and Bavo Europoort, Rotterdam, The Netherlands