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
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