[Jamie89]

The recent controversy around Shelley Duvall/Dr Phil got me thinking about this subject. All the issues surrounding her exploitation etc aside, I heard that he took her to a facility to get treatment but she refused help and so she was released. Seeing that she's clearly mentally disturbed though it made me wonder, that she's suffering from paranoid delusions and it's only going to get worse, in which case why is it that consent for help is even needed? If the problem is with her mental state, then maybe she doesn't have the capacity to make a rational decision regarding her mental health. And if she's only going to deteriorate without help is it not cruel to allow that to happen? I don't know, I assume there are ethical issues, I don't know a lot about the subject or what the treatment even involves, it just made me think is all and I'm curious to know more about it/find out what other peoples opinions are.

Basically, do you think treatment for mental health issues should require consent from the sufferer?

[Jamie89]

According to MHA (Mental Health America)...

"involuntary treatment should only occur as a last resort and should be limited to instances where persons pose a serious risk of physical harm to themselves or others in the near future"

Serious mental illness doesn't get better on it's own though right? So why wait until someone deteriorates to the point where they're a physical danger to themselves/others?

[Withano]

I can't think of any forms of therapy that would work without an active attempt from the client, off the top of my head. Also if they're not gonna take and adhere to the medication, they wont recover.

It does seem wrong is keeping them prisoner and forcing them to spend their time in something that would not work any more moral?

I don't know about the case you're talking about but I presume there will be an intervention coming up or has that already failed too? People can't be forced into help, but they occaisionally change their minds after interventions from friends and family

Paranoid delusions is best treated (still a pretty ****ty success rate) with a combination of cognitive behavioural therapy and atypical medication. They both require an active attempt from the client or it will fail, and an active attempt still might result in failure.

I've never heard of involuntary treatment, it sounds pretty interesting but I'd imagine the success rate is very close to zero

[Jamie89]

Originally Posted by Withano

I can't think of any forms of therapy that would work without an active attempt from the client, off the top of my head. Also if they're not gonna take and adhere to the medication, they wont recover.

It does seem wrong is keeping them prisoner and forcing them to spend their time in something that would not work any more moral?

I don't know about the case you're talking about but I presume there will be an intervention coming up or has that already failed too? People can't be forced into help, but they occaisionally change their minds after interventions from friends and family

Paranoid delusions is best treated (still a pretty ****ty success rate) with a combination of cognitive behavioural therapy and atypical medication. They both require an active attempt from the client or it will fail, and an active attempt still might result in failure.

I've never heard of involuntary treatment, it sounds pretty interesting but I'd imagine the success rate is very close to zero

Yeah I was just reading a bit more and it does seem like the sufferer has to be actively involved in the treatments for them to be considered beneficial, I wasn't really aware of that, so I suppose if it's not going to help them then yeah it wouldn't really be moral to force it onto them. Although saying that, if they treat people who don't consent in extreme cases, then it can't be totally useless, otherwise why intervene? I don't know, I think I need to read more about it

I'm not really sure what's happening with the case I mentioned, I heard that there's a go fund me page for her (to pay for treatment) but again, if she doesn't want it I'm not sure if anything would come of it. (Apparently the reason she refused treatment is because she's worried that the doctors will try and kill her )

[Withano]

Originally Posted by Jamie89

Yeah I was just reading a bit more and it does seem like the sufferer has to be actively involved in the treatments for them to be considered beneficial, I wasn't really aware of that, so I suppose if it's not going to help them then yeah it wouldn't really be moral to force it onto them. Although saying that, if they treat people who don't consent in extreme cases, then it can't be totally useless, otherwise why intervene? I don't know, I think I need to read more about it

I'm not really sure what's happening with the case I mentioned, I heard that there's a go fund me page for her (to pay for treatment) but again, if she doesn't want it I'm not sure if anything would come of it. (Apparently the reason she refused treatment is because she's worried that the doctors will try and kill her )

Ouch, yeah, that's a trickier case than most. I guess group therapy or art therapy might work better for her.. but I suppose if she thinks Doctors are trying to kill her, then medication is out the window and treating her delusions without minimising her negative symptoms will be difficult.

I don't know anything about involuntary treatment, I'll have to Google it tonight.. I'd honestly imagine its probably less to do with aiding their progress, and just a way for proffessionals to check up on them and keep them away from harm.. note down any unusual changes, maybe hide the weapons, maybe look for blood, bruises or scars, maybe analyse something theyve written down or drawn (I'm imagining it would take place at the clients house?)... Could also possibly be used as a way to gain their trust and gradually ease them into a consistent effective therapy in the best case scenarios... But in the case study you posted, if delusions aren't being treated at all, this probably will never happen because she's only going to get more paranoid with those around her.

Edit: I was wrong, involuntary treatment is exactly what it sounds like. Pretty shocked tbh, but, I suppose if they are a direct danger to themselves or others, then it is the more moral thing to do

[DemolitionRed]

Sectioning someone is only ever used as a last resort. They have to pose a risk to others or themselves and under the mental capacity act it has to be proven that they lack the capacity to make their own decisions about their care and treatment. I don’t know anything about the case you’re talking about. If she’s been properly assessed, diagnosed and medicated and if she’s taking her medication, then she should be seeing improvements. If she’s getting worse then she probably needs to be reassed as an inpatient and if she’s refusing that help, then she could, depending on circumstances, end up being sectioned.

Unfortunately, it can be quite difficult to section someone for more than 72 hours which isn’t nearly enough time to properly assess someone’s mental status and give them the help they need. It becomes a bit of a revolving door for that person needing help.

Mental illness is rife and not everyone with mental illness needs to be sectioned but some do. Lets put it this way. People die every day in this country because there isn't adequate facilities to properly section them.

Mental illness slips through the NHS net more than any other illness.

[Toy Soldier]

The reason it's a last resort is because forcing someone to do something against their will (anyone, no matter what their mental state) is further damaging to their mental health. This is obviously magnified when the person is already suffering. It obviously has to be done when someone is posing an actual physical risk to themselves or especially others, though.

[DemolitionRed]

Originally Posted by Toy Soldier

The reason it's a last resort is because forcing someone to do something against their will (anyone, no matter what their mental state) is further damaging to their mental health. This is obviously magnified when the person is already suffering. It obviously has to be done when someone is posing an actual physical risk to themselves or especially others, though.

Absolutely and this is why its very, very difficult to section someone. Under the mental capacity act we have to presume capacity until proven otherwise and even when its been proven that a person does not have capacity, the least restrictive option has to be adhered to.

Sectioning someone for 72 hours is nearly always damaging to that person but sectioning someone in a proper caring facility for a longer period of time will usually be very beneficial for the simple reason that they will find themselves amongst experts. Med professionals will, probably for the first time since their diagnosis, be able to help them.

Those who don’t have mental capacity are not criminals and they aren’t treated as criminals. Most of us imagine straight jackets and padded cells with uncaring brutal staff. Its nothing like that. Modern day staff who work within the mental health section are some of the most caring, patient and understanding people in the medical profession.

[Jamie89]

Originally Posted by DemolitionRed

Sectioning someone is only ever used as a last resort. They have to pose a risk to others or themselves and under the mental capacity act it has to be proven that they lack the capacity to make their own decisions about their care and treatment. I don’t know anything about the case you’re talking about. If she’s been properly assessed, diagnosed and medicated and if she’s taking her medication, then she should be seeing improvements. If she’s getting worse then she probably needs to be reassed as an inpatient and if she’s refusing that help, then she could, depending on circumstances, end up being sectioned.

Unfortunately, it can be quite difficult to section someone for more than 72 hours which isn’t nearly enough time to properly assess someone’s mental status and give them the help they need. It becomes a bit of a revolving door for that person needing help.

Mental illness is rife and not everyone with mental illness needs to be sectioned but some do. Lets put it this way. People die every day in this country because there isn't adequate facilities to properly section them.

Mental illness slips through the NHS net more than any other illness.

That reminds me actually, in the case of Shelley Duvall she was there for 3 days so I guess that's what probably happened, that she was sectioned but released for refusing to cooperate. (I don't know that's definitely what happened it just fits with what you're saying).

Originally Posted by DemolitionRed

Mental illness is rife and not everyone with mental illness needs to be sectioned but some do.

I completely agree with that btw, just to clarify it's only people who are clearly severely mentally disturbed that I'm talking about.

Originally Posted by Toy Soldier

The reason it's a last resort is because forcing someone to do something against their will (anyone, no matter what their mental state) is further damaging to their mental health. This is obviously magnified when the person is already suffering. It obviously has to be done when someone is posing an actual physical risk to themselves or especially others, though.

I suppose, I just find it really sad that someone would be left to get to the point where they're physically hurting themselves before intervention, if it's someone without any family caring for them for example who doesn't want to seek treatment, but they are still severely mentally disturbed. I totally understand their rights but at the same time it must be awful for them, especially when their 'will' is based on what we know to be delusions or their inability to assess that they need help. Like DR said it has to be 'proven' they don't have the capacity, and the proof is that they've hurt themselves or others, but why can't that proof extend to other factors where no physical damage has yet been caused, where it's clear to anyone that they're dealing with severe mental illness, but haven't yet damaged themselves physically and seriously. Because at the very least, even if the 'treatment' doesn't help them a great deal in recovering from their illness, at least they'd be in a safe space where they're not left to deteriorate and begin hurting themselves.

[empire]

sadly even to today we are still viewing mental illness with a taboo, and many people refuse to be treated for it because they feel shamed in some way of thinking, and as far back as the 1970s, patents where used as guinea pigs for drug and surgery experiments, and it caused many deaths and disabilities in many patents, and today the mental health society has to walk on egg shells with consent because of the past, but the mental health people have the right to section people who are a danger to themselves and others, look at paul gascoigne, that guy has alot of problems with his mental health, and when he was sectioned a few times, they had to let him go after a few weeks because he wanted to go, and they knew he was better off being sectioned for a full year rather than a few weeks a time, but it was his consent to leave that has made it worse for him,