Coercive Care

There has been much debate about mental health law reform and mental capacity legislation in recent years with the UN Convention on the Rights of Persons with Disabilities also having a major impact on thinking about the issue. This edited volume explores the concept of ‘coercive care’ in relation to individuals such as those with severe mental illnesses, those with intellectual and cognitive disabilities and those with substance use problems. With a focus on choice and capacity the book explores the impact of and challenges posed by the provision of care in an involuntary environment. The contributors to the book look at mental health, capacity and vulnerable adult’s care as well as the law related to those areas. The book is split into four parts which cover: human rights and coercive care; legal capacity and coercive care; the legal coordination of coercive care and coercive care and individuals with cognitive impairments. The book covers new ground by exploring issues arising from the coercion of persons with various disabilities and vulnerabilities, helping to illustrate how the capacity to provide consent to treatment and care is impaired by reason of their condition.

Coercive Care asks probing and challenging questions regarding the use of coercion in health care and the social services. The book combines philosophical analysis with comparative studies of social policy and law in a large number of industrialized countries.

Coercive medico-legal interventions are often employed to prevent people deemed to be unable to make competent decisions about their health, such as minors, people with mental illness, disability or problematic alcohol or other drug use, from harming themselves or others. These interventions can entail major curtailments of individuals’ liberty and bodily integrity, and may cause significant harm and distress. The use of coercive medico-legal interventions can also serve competing social interests that raise profound ethical, legal and clinical questions. Examining the ethical, social and legal issues involved in coerced care, this book brings together the views and insights of leading researchers from a range of disciplines, including criminology, law, ethics, psychology and public health, as well as legal and medical practitioners, social-service ‘consumers’ and government officials. Topics addressed in this volume include: compulsory treatment and involuntary detention orders in civil mental health and disability law; mandatory alcohol and drug treatment programs and drug courts; community treatment orders; the use of welfare cards with Indigenous populations; mandated treatment of seriously ill minors; as well as adult guardianship and substituted decision-making regimes. These contributions attempt to shed light on why we use coercive interventions, whether we should, whether they are effective in achieving the benefits that are offered to justify their use, and the impact that they have on some of society’s most vulnerable citizens in the names of ‘justice’ and ‘treatment’. This book is essential reading for clinicians, researchers and legal practitioners involved in the study and application of coerced care, as well as students and scholars in the fields of law, medicine, ethics and criminology. The collection asks important questions about the increasing use of coercive care that demand to be answered, and offers critical insights, guidance and recommendations for those working in the field.

The United States faces a growing crisis in care. The number of people needing care is growing while the ranks of traditional caregivers have shrunk. The status of care workers is a critical concern. Evelyn Nakano Glenn offers an innovative interpretation of care labor in the United States by tracing the roots of inequity along two interconnected strands: unpaid caring within the family; and slavery, indenture, and other forms of coerced labor. By bringing both into the same analytic framework, she provides a convincing explanation of the devaluation of care work and the exclusion of both unpaid and paid care workers from critical rights such as minimum wage, retirement benefits, and workers' compensation. Glenn reveals how assumptions about gender, family, home, civilization, and citizenship have shaped the development of care labor and been incorporated into law and social policies. She exposes the underlying systems of control that have resulted in womenÑespecially immigrants and women of colorÑperforming a disproportionate share of caring labor. Finally, she examines strategies for improving the situation of unpaid family caregivers and paid home healthcare workers. This important and timely book illuminates the source of contradictions between American beliefs about the value and importance of caring in a good society and the exploitation and devalued status of those who actually do the caring.

The use of coercion is one of the defining issues of mental health care. Since the earliest attempts to contain and treat the mentally ill, power imbalances have been evident and a cause of controversy. There has always been a delicate balance between respecting autonomy and ensuring that those who most need treatment and support are provided with it. Coercion in Community Mental Health Care: International Perspectives is an essential guide to the current coercive practices worldwide, both those founded in law and those 'informal' processes whose coerciveness remains contested. It does so from a variety of perspectives, drawing on diverse disciplines such as history, law, sociology, anthropology and medicine to provide a comprehensive summary of the current debates in the field. Edited by leading researchers in the field, Coercion in Community Mental Health Care: International Perspectives provides a unique discussion of this prominent issue in mental health. Divided into five sections covering origins and extent, evidence, experiences, context and international perspectives this is ideal for mental health practitioners, social scientists, ethicists and legal professionals wishing to expand their knowledge of the subject area.

Argues that laws that enforce what is good for the individual's well-being, or hinder what is bad, are morally justified.

Coercion is one of the most fascinating and controversial subjects in psychiatry. It is a highly sensitive, and hotly debated topic in which clinical practice, ethics, the law and public policy converge. This book considers coercion within the healing and ethical framework of therapeutic relationships and partnerships at all levels, and addresses the universal problem of how to balance safety versus autonomy when dealing with psychiatric treatment. Coercive Treatment in Psychiatry is a much needed contribution to the literature. The first three sections deal with the conceptual and clinical aspects of coercive treatment, the legal aspects and the ethical aspects of coercive treatment. In detail, these sections cover a broad spectrum of issues: coercion in institutions and in the community, coercive treatment and stigma, the definition of best practice standards for coercive treatment, de-escalation of risk situations, recent developments in mental health legislation, mental health care and patients' rights, cross-cultural perspectives on coercive treatment, historical injustice in psychiatry, and paternalism in mental health. The fourth section features users' views on coercive treatment: giving voice to an often-unheeded population. Finally, the book addresses the original topic of coercion and undue influence in decisions to participate in psychiatric research. This book presents the first comprehensive review of the issue of coercion in psychiatry. With chapters written by the leading experts in the field, many of whom are renowned as clear thinkers and experienced clinicians, it may be seen as a starting point for international discussions and initiatives in this field aiming to minimize coercion. Highly Commended in the Psychiatry section of the 2012 BMA Book Awards.

This book presents the legal context and describes the ethical and practical challenges when using coercive measures in forensic psychiatric settings. A wide range of aspects relevant to the use of such measures, including environmental, patient-related, and staff-related factors, are explored, and the experience of coercive interventions is described from the staff and the patient perspective. Differences in jurisdictions and examples of good practice are highlighted. The authors are from a range of professional backgrounds, ensuring breadth as well as depth in discussion of the topic. The use of coercive measures, in particular restraint, seclusion, and involuntary medication, for the control of aggression in psychiatry remains controversial. Forensic mental health care deals with individuals who pose a risk to others and often present with significant management problems within institutions. The care of patients in these settings gives rise to debates about the balance between care and safety, and between the interests of the patients and those of the wider society to be protected. Despite these tensions, limited research has been conducted specifically on the use of coercive measures in forensic mental health care. This volume aims to fill the gap and will be of value to all professionals working in forensic psychiatric settings as well as to those working in general psychiatric and custodial settings, law professionals, and patients.