BMJ  2004;329:122-123 (17 July), doi:10.1136/bmj.329.7458.122

Editorial

Compulsion and psychiatry—the role of advance statements

Liberation cannot be handed to the oppressed by the oppressor

The first 150 words of the full text of this article appear below.

Most psychiatrists accept reluctantly that from time to time they need to force patients to have treatment against their wishes. The British government's proposed changes to the Mental Health Act will increase compulsion in three ways. They will remove the requirement that a patient's condition must be severe enough to warrant admission to hospital, thus enabling compulsory treatment in the community; they will re-incorporate people with personality disorder; and they will introduce wider definitions of mental disorder and of treatment. Users of mental health services have long been concerned about compulsion and have tried to combat it. Twenty years ago groups such as Survivors Speak Out pioneered the use of crisis cards as a way of resisting compulsion in mental health emergencies. More recently, partly in response to the proposed legislation but also as part of a growing critical debate within the profession, psychiatrists have turned to advance statements (or . . . [Full text of this article]

Bradford Assertive Outreach Team, Centre for Citizenship and Community Mental Health, School of Health Studies, University of Bradford, Bradford BD7 0BB (p.thomas@bradford.ac.uk)

Bradford District Care Trust, Shipley BD18 3LD

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Relevant Article

Effect of joint crisis plans on use of compulsory treatment in psychiatry: single blind randomised controlled trial

Claire Henderson, Chris Flood, Morven Leese, Graham Thornicroft, Kim Sutherby, and George Szmukler
BMJ 2004 329: 136. [Abstract] [Full Text] [PDF]

This article has been cited by other articles:

• Henderson, C., Swanson, J. W., Szmukler, G., Thornicroft, G., Zinkler, M. (2008). A Typology of Advance Statements in Mental Health Care. Psychiatr. Serv. 59: 63-71 [Abstract] [Full text]  
• Zinkler, M., Amering, M., Stastny, P., Hopper, K. (2005). Advance directives and advance agreements * Authors' reply:. Br. J. Psychiatry 187: 388-389 [Full text]  

Rapid Responses:

Read all Rapid Responses

The new millennium mental health act probably will double the number of patients being detained under the new act?

AK Al-Sheikhli
bmj.com, 17 Jul 2004 [Full text]

Re: The new millennium mental health act probably will double the number of patients being detained under the new act?

Rita Pal
bmj.com, 17 Jul 2004 [Full text]

Compulsory "service users"

Anthony Stadlen
bmj.com, 19 Jul 2004 [Full text]

True!

Dr.G.Chidambaran Chidambaran
bmj.com, 26 Jul 2004 [Full text]

Compulsory treatment can be liberating

Trevor H Turner
bmj.com, 29 Jul 2004 [Full text]

The Tzar of mental health and the increasing abandonment of human liberties in UK

susanne mccabe
bmj.com, 9 Sep 2004 [Full text]

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