The ability to make decisions about your life – including the right to choose your own mental.
Health care is the key to human autonomy and individuality.
The United Nations Convention on the Rights of Persons with Disabilities (CRPD) obliges countries to recognize that people with mental disabilities have legal capacity on an equal basis with everyone else. Nevertheless, involuntary hospitalization and care against the will of a person suffering from a mental illness is regularly and widely practiced throughout the world. This coercion is facilitated by laws and practices that give guardians of people with mental disorders extensive powers to change decisions.
Voices of experience
Due to alternative decision making, people with mental illness lose their rights to informed consent, confidentiality, privacy and communication with family members. Often people are placed in institutions and subjected to isolation or restrictions.
People who have been cared for without their consent report feeling inhuman, often with long-term consequences for their mental well-being. The practice of coercion undermines people’s confidence and trust in mental health services and can prevent people from seeking help when they need it.
Forced treatment can also aggravate existing conditions. Alexandra M. Shuster from the United Kingdom was diagnosed with mental illness when she was seven years old. “As a child and teenager, I had no say in my own recovery: my own ideas of what was right for me were often ignored,” Alexandra says. “This lack of self-reliance undermined my already low self-esteem and exacerbated my mental illness.”
Alexandra says that by the age of nineteen, she was a shell of a person. “Years of forcing me into a certain care path and caring adults have eroded my self-confidence. I had a hard time believing I was capable of making basic decisions, let alone helping myself.”
Positive partnership for care
Respecting people’s autonomy can be challenging, but world best practice shows that it is possible, especially by involving people in their own planning, evaluation and management of health care, for example through collaborative decision-making, expanded planning, support for self-management and treatment-oriented approaches. per person.
Empowering people to take control of their lives and take care of their mental health instills personal dignity, worth and respect. It can boost self-esteem and self-confidence. It also gives people a level of choice and autonomy they might not have otherwise.
“Getting autonomy over my mental health care has been the biggest contributor to my recovery,” Alexandra says. “My current therapist sees me as a person, not a mental illness. [When I first met her]she asked me about interests, wanted to know my style of work, and was eager to work together to pave the way for mental well-being.”
The meaningful participation of people with life experience builds trust and understanding among those who provide and receive care. The potential outcome is better therapeutic relationships and more equitable and effective care partnerships. Individuals and health care providers can work together to map out treatment options and choose the most appropriate and acceptable.
“We started small,” Alexandra recalls, “but with [my therapist’s] guidance, I gradually gained the confidence to make difficult decisions about my health and well-being. Her willingness to partner with me, to create care plans that suited me as a person, yet gave me room to make my own decisions, helped me gain the confidence to thrive not only mentally, but in every other area of my life. To this day, I attribute my recovery to her willingness to cooperate.”
Moving from care that ignores perspectives, priorities and human rights to person-centered, rights-based and recovery-focused care that engages people as active participants rather than passive beneficiaries is one of the twelve key shifts. needed to change mental health for everyone.