Mental Health Advance Choice Documents ‘Would Reduce Sectioning’


From The Guardian: “Fewer people with ‘mental illnesses’ would endure the trauma of being sectioned if advance choice documents – setting out a treatment plan while they are well – were included in Mental Health Act reforms, a leading psychiatrist has said.

Advance choice documents are the only proven way to reduce the number of people detained under the Mental Health Act in England and Wales, which is one of the reforms’ core objectives, said Dr Lade Smith, the president of the Royal College of Psychiatrists.

Research suggests that the use of these documents can reduce compulsory detention rates in psychiatric units, often known as sectioning, by 25%, minimising traumatic experiences for people with ‘bipolar,’ ‘schizophrenia’ and other ‘psychotic illnesses.’

‘It’s high time there was reform of the Mental Health Act because the rates of detention are increasing, especially for marginalised groups, those who are poor or from a minoritised ethnic community, especially black Caribbean … Advance choice docs were a recommendation of the review, I don’t know why they haven’t gone through,’ said Smith.

Advance choice documents are especially effective in reducing the significantly higher detention rates for black people with ‘mental illnesses,’ as they can help patients feel more autonomous and reduce unconscious bias.

The documents can also speed up and improve recovery, and reduce the time spent in hospital, which can have a negative impact on patients’ jobs, homes or relationships, said Smith.”

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  1. I find this a little confusing and here’s why: Is it possible that the same thing happens in Great Britain that happens here? We are told that Advance Directives will solve big problems, but we have discovered that the hospital doctors and staff have their clever ways of neutralizing the effect of Advance Directives. Nevertheless, I’m glad that The Guardian printed the article so that people will write in and tell the truth.

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  2. The Guardian article seems to be promoting the use of ECT, and it omits reference to the need to identify and resolve infections and inflammatory conditions that perturb the HPA axis which triggers mania/psychotic mania in those who are vulnerable; what a combustible pairing of dangerous elements.
    [ Convenient google search: The hypothalamic-pituitary-adrenal axis (HPA) is the main stress response system. It is the neuroendocrine link between perceived stress and physiological reactions to stress (Breedlove and Watson, 2013 Jun 15, 2018]
    Infections and the antibiotics to resolve them may trigger a mania. The toxicity of clozapine was so pronounced in one patient over five years that she developed inflammatory pathology in multiple organ systems and in that condition she developed psychotic mania. Delay of diagnosis and treatment of the patient’s inflamed medical issues underlying a psychiatric breakdown is cruel , medical neglect, and increases risk to the patient of inappropriate treatments and their dangerous adverse events such as those inflicted with the use of Electro-Convulsive Shock.
    The psychiatric wards have dangerous conflicts of interest; they seem to be keenly bent on finding candidates for ECT. Is their incentive a lucrative reimbursement, or the goal of conducting doctoral or post-doc research, etc? I’ve seen a patient forcibly left for many weeks to suffer in a state of stressful akathisia on an antipsychotic we knew was a problem, and the attending physician was threatening said patient with ECT. Finally the medication was withdrawn and the patient status improved withOUT ECT. This was just one of many surreal, dystopian, hellish experiences within the psychiatric system.

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