Supporting and implementing alternatives to coercion in mental health care

The use of coercion in mental healthcare has long been subject to controversy, and the call for viable alternatives is growing both within the profession and among people with lived experience of coercion in mental healthcare.

Advocates for change aim to maximise therapeutic outcomes and promote the rights and recovery of people with mental health conditions and associated psychosocial disabilities. Research and guidance is now available to support the implementation of alternatives to coercion in low-income, middle-income and high-income countries. Service managers, clinicians, and people with lived experience and their families all can play a central role in leading change. With appropriate resources the services can, for example, pursue WHO QualityRights assessment and transformation processes and promote initiatives explicitly aimed at implementing alternatives to coercion.

 

An effective and long-lasting change can only take place in a recovery oriented system of care, in which respect for human rights and service user involvement are not only required, but realised through sound pathways to non-coercive care. This includes attention to all the important steps along the way – prevention, early intervention, and continuity beyond clinical settings to provide integrated and personalised care. Meaningful involvement by persons with lived experience of mental health problems and psychosocial disabilities and their families bring crucial insight and momentum irrespective of where the services are in their development.

Resources for implementing alternatives to coercion

The WPA is committed to supporting mental health professionals and their organisations to implement alternatives to coercion. To this end, the WPA is working with the RANZCP and other partners to produce the following resources:

WPA Position Paper and Call To Action

Implementing Alternatives to Coercion: A Key Component of Improving Mental Health Care 

Implementing Alternatives to Coercion in Mental Health Care Working Group

The WPA Working Group (WG) on Implementing Alternatives to Coercion in Mental Health Care has been tasked with the following:

  1. To identify topics related to improvement of the quality and safety of mental health services and implementation of sound alternatives to coercion, that are of interest for all stakeholders, and develop recommendations for WPA’s involvement in research, education and service development relevant to dealing with problems of quality and safety of mental health services.

  2. To identify member societies, institutions and individuals interested and willing to participate in WPA’s programs of research, service development and education related to the implementation of alternatives to coercion.

  3. To liaise with the other WPA Action Plan Working Groups on quality and safety of mental health services with a view to ensure that problems of respect for dignity and human rights of people with mental disorders, and related advocacy activities, are considered in the work of these groups and vice versa.

Members

Working Group Coordinators

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John Allan

MBBS, FRANZCP, PhD, GAICD

MBBS, FRANZCP, PhD, GAICD

Associate Professor

President of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) until May2021

Executive Director of Mental Health Alcohol and other Drugs Branch, Clinical Excellence Division in Queensland Health

School of Medicine University of Queensland

15 Butterfield St Herston, Brisbane 4030 Australia

 

Email: John.Allan@ranzcp.org

Read Professor Allan’s biography here

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Silvana Galderisi

MD, PhD

Full Professor of Psychiatry

University of Campania Luigi Vanvitelli

Naples, Italy

Phone +39 081 5565155

 

silvana.galderisi@gmail.com

Read Professor Galderisi’s biography here

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Helen Herrman

MD, MBBS, BMedSc, FRANZCP, FFPH, FAFPHM

MD, MBBS, BMedSc, FRANZCP, FFPH, FAFPHM

Professor Emeritus of Psychiatry, Orygen and Centre for Youth Mental Health,

The University of Melbourne

Parkville, Victoria, Australia

Read Professor Herrman’s biography here

Working Group Members

Michaela Amering

MD Univ. Prof. Dr.

Clinical Division of Social Psychiatry

Department of Psychiatry and Psychotherapy

Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria

Phone +43 1 40400 35460

Email: michaela.amering@meduniwien.ac.at

Read Professor Amering’s biography here

Neeraj Gill

MBBS; MD (Psychiatry); FRANZCP; DrPH

Professor, School of Medicine, Griffith University,

Gold Coast, Australia

Consultant Psychiatrist, Gold Coast Health, QLD, Australia

Email: neerajgill@griffith.edu.au

Read Professor Gill’s biography here

Andreas Heinz

Prof. Dr. med. Dr. phil.

Director and Chair, Professor (W3)

Department of Psychiatry and Psychotherapy

Charité – Universitätsmedizin Berlin, Charité Campus Mitte

Charitéplatz 1, 10117 Berlin, Germany

Phone: +49 (30) 450 517 001 andreas.heinz@charite.de

Read Professor Heinz’s biography here

Guadalupe Morales

Bachelor Degree in Communication and Journalism

Director of Fundación Mundo Bipolar

Madrid, Spain

Email: gm@mundobipolar.org

Read Dr Morales’ biography here

Soumitra Pathare

MD DPM MRCPsych PhD

Director, Centre for Mental Health Law and Policy, Indian Law Society

Pune, India

Phone +91-9370666191

 

Email: spathare@cmhlp.org

Read Dr Pathare’s biography here

Maria Rodrigues

.

BA (Psychology) Elmira College, New York, USA

PhD (Applied Ethics) The University of Melbourne, Australia

Lead Researcher, Community Works

Melbourne, Australia

Email: maria@communityworks.com.au

Read Dr Rodrigues’ biography here

Martha Kane Savage

.

PhD in Geophysics, FRSNZ, Fellow of the American Geophysical Union

Wellington, New Zealand

Phone +644635961

 

Email: martha.savage@vuw.ac.nz

Read Professor Savage’s biography here

Working Group Advisors

Paul S. Appelbaum

MD

Dollard Professor of Psychiatry, Medicine, & Law

Columbia University Vagelos College of Physicians & Surgeons

New York, NY, USA

Phone 646-774-8630

 

Email: Paul.Appelbaum@nyspi.columbia.edu

Read Professor Appelbaum’s biography here

Natalie Drew Bold

MA Human Rights

Technical Officer, Policy Law and Human Rights, Department of Mental Health and Substance Use, WHO

20 Avenue Appia, CH-1211 Geneva 27, Switzerland

Phone +41227913206

 

Email: drewn@who.int

Read Dr Drew Bold’s biography here

Michelle Funk

BSc (Hons),, MPsych, PhD

Unit Head, Policy, law and human rights, Department of Mental Health and Substance Abuse, World Health Organization

Switzerland

Phone +41-22 791 3855

 

Email: funkm@who.int

Read Dr Funk’s biography here

Shigenobu Kanba

MD, PhD

Professor Emeritus, Kyushu University

Nagano Prefecture, Japan

 

Email: kanba.shigenobu.921@m.kyushu-u.ac.jp

Read Professor Kanba’s biography here

Pratima Murthy

MD DPM FRCP (Glasgow)

Professor and Head, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS)

Bangalore, India

Phone +91-9844094482

 

Email: pratimamurthy@gmail.com

Read Professor Murthy’s biography here

George Szmukler

MB BS, DPM, MD, FRICPsych

Fellow King’s College

London, UK

 

Email: george.szmukler@kcl.ac.uk

Read Professor Szmukler’s biography here

Working Group Board and ECP Representative

Working Group Coordinators

Juliet Nakku

Butabika Hospital, P.O.Box 7017, Kampala Email : jnakku@yahoo.com 

Working Group Coordinators

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Amine Larnaout

Immeuble 1, appartement 7, cité Les Oliviers, Menzah 6, Ariana 2091; Tunisia

Email: larnaout.amin@gmail.com

Working Group members and advisors list can be downloaded here

Deliverables

  • Symposium, workshop, forum other type of meeting 

  • Webinar(s) 

  • Position papers, reports, guidelines 

  • Digital/online, print version documents 

  • Articles in journals, books 

  • Products distributable through social media (eg short videos) 

  • Research protocols and studies 

  • Training programs 

  • Collaboration with other organisations working in this field 

This Discussion Paper from the WPA Taskforce outlines recent developments in practice, research and international human rights law concerning coercion in mental health settings with the aim of supporting psychiatrists and other mental health professionals in their work towards improving the quality and safety of mental health services and putting sound alternatives to coercion in place.  Download the Discussion Paper HERE

Implementing Alternatives to Coercion: Examples from Practice

A set of three case studies designed to share experiences and promote understanding of existing efforts to generate change in settings operating under varying social, cultural, and economic conditions. It aims to encourage and support mental health professionals around the world to work with people with lived experience, service providers and other partners to put alternatives to coercion into practice. It should be noted that the WPA has neither implemented nor evaluated the work described in the case studies.  Where available, links to full case studies are included below.

  • Campo Abierto, Colombia – an example of a health facility implementing alternatives to coercion 

  • Quality Rights Gujarat, India – an example of implementing alternatives to coercion at the state level

  • Towards eliminating coercion in Australia and New Zealand – an example of implementing alternatives to coercion at the national level