Advance Directives & Substitutes

Various instruments of the United Nations have commented on forced treatment, or involuntary confinement, or both (for details, see Burstow, 2015a), and a number of truly critical additions to international law have materialized. Arguably, the most significant of these is the Convention on the Rights of Persons with Disabilities. What makes it so significant? For one thing, it is because this landmark convention puts forward nothing less than a total ban on both involuntary treatment and the involuntary confinement of people who have broken no laws.

Martha Rosenberg highlights how the popular antipsychotic Seroquel is a perfect example of how direct-to-consumer advertising made billion dollar blockbuster drugs possible before side-effects...

Following an eye-opening FDA report, the Obama administration is attempting to pass tighter regulations on medical tests. “Inaccurate and unreliable medical tests are prompting...

Concerns have been raised about inconsistent and unreliable results, which may lead to injustices in sentencing or even wrongful convictions.

Richard Smith, the chair of the board of trustees at BMJ, penned an editorial yesterday bringing increased scrutiny to research misconduct and medical fraud in the UK. Smith identifies denial about the seriousness of the problem and the reluctance of universities to submit themselves to reviews as the two major reasons that Britain has failed to address these issues.

It is time to create an entirely voluntary psychiatric system. International conscience is clear. The singling out of people with psychosocial disabilities is not worthy of a free society. There are better, safer ways to address legitimate public needs.

In an effort to reduce coercion, researchers isolate associated factors including age, relationship status, location, and diagnosis.

The report has succeeded in being supremely ambitious in its breadth, whilst remaining disappointingly cautious in its goals. The emphasis is on smaller changes in the immediate future, and kicking more progressive reform into the long grass. It alludes to but does not enshrine a rights-based approach.

"HHS said it took pains to avoid any change to gun check reporting that would weaken physician–patient confidentiality and deter individuals from voluntarily seeking...

At a recent conference on legal capacity, I was struck by the failure of another invited expert to adhere to the paradigm of supported decision-making as articulated by the CRPD Committee. We still need to work to ensure that this paradigm is well understood and appreciated, despite the progress made in national reforms.

“The pharma industry loses tens of billions in worldwide sales each year when patients don’t fill, or refill, their prescriptions,” Rebecca Robbins reports for STAT. So...

In MinnPost, Susan Perry discusses a JAMA Internal Medicine study that found that, within 48 hours of being hospitalized, almost half of adults aged...

David Shern, from Johns Hopkins University, writes that the latest mental health “Murphy bill” in Congress is “an expansion of the approaches that got us into our current difficulties.” “Early intervention and prevention, assessable and patient-focused services with a rehabilitation orientation and increased funding for the community supports needed for successful recovery are the tickets to system improvement.”

On Friday, Psych Rights won a legal fight in Alaska Supreme Court reversing an order for an involuntary psychiatric evaluation. Opinion →

Most Americans would agree that we have problem with mental health in this country, but what many do not know when they consider that people who are in distress are not getting the help they need is that hospitals in this country are not giving people a choice when they are in the most need. This is based on laws that currently exist in 45 US States, which allow individuals to be petitioned into an inpatient psychiatric unit against their will if they are deemed to be a “danger to themselves or others.” I have worked for 3.5 years as a Peer Support Specialist within my local public mental health system, where I see this happen to the individuals I serve, on a regular basis. I myself have been forced.

Two facts about Robert Califf are beyond question. He is an expert on clinical trials, who is already seen as a leading architect of the future of medical research. And as the New York Times put it, he has “deeper ties to the pharmaceutical industry than any FDA commissioner in recent memory”. A lot of senior figures in medicine support Califf in spite of his ties to Pharma. The guy is just so bright, and understands the nuts and bolts of drug research so well! Surely a person like this is more useful than some outsider who offers only a squeaky-clean resume, they argue.

Researchers examine psychiatrist-client interactions and find that clients are often left with few opportunities to make explicit requests to change their medication regimen.

Oryx Cohen at TruthOut explains why the "Helping Families in Mental Health Crisis Act (HR 2646) - commonly known as the 'Murphy Bill' - appears to cater more closely to the desires of pharmaceutical companies than to the actual needs of people in psychological distress, perhaps because of Murphy's connections to key lobbyists." "If the Murphy Bill is passed, psychiatric hospitals and pharmaceutical companies will reap huge financial benefits as a result of increased hospitalization and forced treatment."

I lived through forced ECT from 2005-2006 at the Institute of Living in Hartford, Connecticut. My experience with ECT was the impetus for me to become involved in the antipsychiatry and Mad Pride movements, although I am not entirely opposed to voluntary mental health treatment. The following is the comment I submitted to the FDA on its proposal to down-classify the ECT shock device.

The science magazine RUBIN provides an update on patients’ rights to refuse treatment in Germany's psychiatric wards. “In psychiatric wards in Germany, patients used to be medicated indiscriminately against their will if doctors considered it necessary. It was only after a Federal Constitution Court ruling a few years ago that patient autonomy has been strengthened.”

In this piece for STAT, Jennifer Adaeze Okwerekwu describes the value of psychiatric advance directives for those at risk of experiencing an emotional crisis. "'It’s something that can...

A discussion of the role of epistemic injustice in the experiences of patients diagnosed with psychiatric disorders.

A recent article in the American Journal of Public Health calls for policy level interventions to reduce the use of benzodiazepines, drugs commonly prescribed...

In The Opinion Pages of the New York Times, Matthew Epperson discusses the devastating results of police acting as the primary responders to mental health crises. “If we are to prevent future tragedies, then we should be ready to invest in a more responsive mental-health system and relieve the police of the burden of being the primary, and often sole, responders.”

Researchers believe that side-effect monitoring is critical because of the increase in the use of antipsychotics