TY - JOUR

T1 - Use of Compulsory Treatment by Early-Career Psychiatrists: An International Survey

AU - Чумаков, Егор Максимович

AU - Петрова, Наталия Николаевна

AU - Vadivel, Ramya

AU - Pinto da Cpsta, Mariana

AU - Bhugra, Dinesh

AU - Ventriglio, Antonio

PY - 2021/11

Y1 - 2021/11

N2 - Objective: The United Nations Convention on the Rights of Persons with Disabilities (UN CRPD) has been broadly incorporated into national frameworks for compulsory psychiatric treatment. Recently, instructions issued by the UN CRPD Committee discouraged any involuntary treatment and detention of people with mental disabilities, which has sparked clinical, legal, and ethical debates. Early-career psychiatrists (ECPs) are often at the front line of decisions to involuntarily detain psychiatric patients; here, the authors surveyed ECPs to gain insight into their experiences with compulsory psychiatric treatment in clinical practice. Methods: An anonymous, voluntary, online survey among ECPs from 43 countries was conducted between July and August 2019. Results: In total, 142 ECPs completed and were eligible to participate in the survey. Most of the survey respondents reported being involved in the practice of compulsory psychiatric care. More than half reported difficulties in providing compulsory psychiatric care, mostly because of the bureaucracy of legal procedures (e.g., legal correspondence with the court) and ethical issues around detention. Most respondents (96%) generally agreed with their country's legal mechanism for compulsory treatment; 43% indicated that it should remain unchanged, and 53% indicated that it should be revised. Conclusions: These findings call for a broader discussion in society and among psychiatrists regarding the practice of compulsory treatment while giving due consideration to the legal, therapeutic, and ethical issues involved. The views of ECPs will be helpful in future revisions of the ethical and operational frameworks of compulsory psychiatric care. Psychiatric Services 2021; 72:1276-1281; doi: 10.1176/appi.ps.202000303

AB - Objective: The United Nations Convention on the Rights of Persons with Disabilities (UN CRPD) has been broadly incorporated into national frameworks for compulsory psychiatric treatment. Recently, instructions issued by the UN CRPD Committee discouraged any involuntary treatment and detention of people with mental disabilities, which has sparked clinical, legal, and ethical debates. Early-career psychiatrists (ECPs) are often at the front line of decisions to involuntarily detain psychiatric patients; here, the authors surveyed ECPs to gain insight into their experiences with compulsory psychiatric treatment in clinical practice. Methods: An anonymous, voluntary, online survey among ECPs from 43 countries was conducted between July and August 2019. Results: In total, 142 ECPs completed and were eligible to participate in the survey. Most of the survey respondents reported being involved in the practice of compulsory psychiatric care. More than half reported difficulties in providing compulsory psychiatric care, mostly because of the bureaucracy of legal procedures (e.g., legal correspondence with the court) and ethical issues around detention. Most respondents (96%) generally agreed with their country's legal mechanism for compulsory treatment; 43% indicated that it should remain unchanged, and 53% indicated that it should be revised. Conclusions: These findings call for a broader discussion in society and among psychiatrists regarding the practice of compulsory treatment while giving due consideration to the legal, therapeutic, and ethical issues involved. The views of ECPs will be helpful in future revisions of the ethical and operational frameworks of compulsory psychiatric care. Psychiatric Services 2021; 72:1276-1281; doi: 10.1176/appi.ps.202000303

KW - ATTITUDES

KW - COERCION

KW - INVOLUNTARY ADMISSION

KW - LEGAL

KW - MENTAL-HEALTH

KW - PREFERENCES

KW - RIGHTS

KW - UN CONVENTION

KW - WILL

UR - https://www.mendeley.com/catalogue/a78ae859-c3af-37d8-bdb3-05f3830cd9fd/

U2 - 10.1176/appi.ps.202000303

DO - 10.1176/appi.ps.202000303

M3 - Article

VL - 72

SP - 1276

EP - 1281

JO - Psychiatric Services

JF - Psychiatric Services

SN - 1075-2730

IS - 11

ER -