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Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
14:32

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Published on: February 16, 2011

Community-based mental health services: is coercion necessary?

W Patrick Sullivan1, Jenneth Carpenter

  • 1School of Social Work, Indiana University, Indianapolis, Indiana 46202, USA. wpsulliv@iupui.edu

Journal of Social Work in Disability & Rehabilitation
|August 24, 2010
PubMed
Summary

Community mental health services often limit patient choice, justifying coercion by focusing on deficits. Shifting focus to the service system and fostering respectful relationships improves patient engagement and goal achievement.

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Area of Science:

  • Community mental health
  • Psychiatric services
  • Patient rights

Background:

  • Service recipient choice and freedom are often limited in community mental health settings through subtle and overt mechanisms.
  • Coercion in these settings is frequently justified by focusing on perceived deficits of the service recipient.

Purpose of the Study:

  • To challenge the focus on recipient deficits as justification for coercion in community mental health.
  • To advocate for a shift in focus towards the service system itself.
  • To identify key factors for improving service recipient engagement.

Main Methods:

  • Conceptual analysis of coercion and choice in community mental health.
  • Argumentative approach based on service system critique.
  • Focus on provider-recipient relationships and goal-oriented service delivery.

Main Results:

  • Limitation of choice and freedom in community mental health is a significant issue.
  • Current justifications for coercion disproportionately blame service recipients.
  • A service system-centered approach is proposed as a more effective model.

Conclusions:

  • Successful improvement of service recipient engagement requires a paradigm shift from recipient deficits to service system improvements.
  • Fostering respectful provider-recipient relationships is crucial.
  • Delivering services aligned with recipient-chosen goals enhances engagement and outcomes.