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The right to choose treatment-without-treatment: respecting civil rights or an unprecedented manifestation of ‘reverse stigma’?

Published online by Cambridge University Press:  12 October 2018

Konstantinos N Fountoulakis*
Affiliation:
3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
Kyriakos Souliotis
Affiliation:
Faculty of Social and Political Sciences, University of Peloponnese, Peloponnese, Greece
*
Author for correspondence: Konstantinos N Fountoulakis, Aristotle University of Thessaloniki, 6, Odysseos str (1st Parodos Ampelonon str.), 55535 Pylaia Thessaloniki, Greece. Tel: +30 2310 435702; Fax: +30 2310 266570. E-mail: kfount@med.auth.gr

Abstract

Recently the Norwegian Health Minister ordered the creation of medication-free treatment wards as a result of the lobbying by patients’ groups and activists. The idea behind this is that patients should have the right to choose their treatment, but for the first time, with this arrangement, the user/patient does not choose between treatment options; he literally determines by himself what efficacious treatment is. In our opinion this is another step towards a ‘reverse stigma’ which denies patients the right to be considered as such and eventually kicks them out of the health care system, deprives them of the right for proper treatment and care and instead puts them at the jurisdiction of the much cheaper and ineffective social services.

Type
Perspective
Copyright
© Scandinavian College of Neuropsychopharmacology 2018 

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References

1. Withtaker, R (2017) The Door to a Revolution in Psychiatry Cracks Open. Mad in America. Available at https://www.madinamerica.com/2017/03/the-door-to-a-revolution-in-psychiatry-cracks-open/. Accessed August 13, 2017.Google Scholar
2. Ringard, A, Saunes, ISSagan, A (2016) The 2015 hospital treatment choice reform in Norway: continuity or change? Health Policy 120, 350355.Google Scholar
3. Breggin, P (1993) Toxic Psychiatry: Drugs and Electroconvulsive Therapy: The Truth and the Better Alternatives. London: HarperCollins.Google Scholar
4. Riley, H, Straume, BHoyer, G (2017) Patients on outpatient commitment orders in Northern Norway. BMC Psychiatry 17, 157.Google Scholar
5. Lovsletten, M, Haug, E, Granerud, A, Nordby, KSmaaberg, T (2016) Prevalence and management of patients with outpatient commitment in the mental health services. Nord J Psychiatry 70, 401406.Google Scholar
6. Rugkasa, J, Molodynski, A, Yeeles, K, Vazquez Montes, M, VisserC, C, Burns, Tand Octet Group (2015) Community treatment orders: clinical and social outcomes, and a subgroup analysis from the OCTET RCT. Acta Psychiatr Scand 131, 321329.Google Scholar
7. Togersen, K, Bjerke, E, Gjelstad, KRuud, T (2015) Compulsory hospitalisation in mental health care in Ostfold in 2000 and 2010. Tidsskr Nor Laegeforen 135, 3134.Google Scholar
8. Norum, J, Olsen, A, Nybrodahl, ISorgaard, KW (2013) Compulsory and voluntary admission in psychiatric hospitals in northern Norway 2009-2010. A national registry-based analysis. Nord J Psychiatry 67, 4752.Google Scholar
9. Bergem, A (2016) Treatment without medication. Nord Psychiatrist 2, 8.Google Scholar
10. Røssberg, J, Andreassen, OIlner, S (2017) Medication-free hospital records - a measure not based on knowledge. Tidsskr Nor Laegeforen 137, 426427.Google Scholar
11. Hegelstad, WT, Larsen, TK, Auestad, B, Evensen, J, Haahr, U, Joa, I, Johannesen, JO, Langeveld, J, Melle, I, Opjordsmoen, S, Rossberg, JI, Rund, BR, Simonsen, E, Sundet, K, Vaglum, P, Friis, SMcGlashan, T (2012) Long-term follow-up of the TIPS early detection in psychosis study: effects on 10-year outcome. Am J Psychiatry 169, 374380.Google Scholar
12. Murray, RM, Quattrone, D, Natesan, S, van Os, J, Nordentoft, M, Howes, O, Di Forti, MTaylor, D (2016) Should psychiatrists be more cautious about the long-term prophylactic use of antipsychotics? Br J Psychiatry 209, 361365.Google Scholar
13. Alvarez-Jimenez, M, O’Donoghue, B, Thompson, A, Gleeson, JF, Bendall, S, Gonzalez-Blanch, C, Killackey, E, Wunderink, LMcGorry, PD (2016) Beyond clinical remission in first episode psychosis: thoughts on antipsychotic maintenance vs. guided discontinuation in the functional recovery era. CNS Drugs. 30, 357368.Google Scholar
14. Wunderink, LSytema, S (2014) Early medication discontinuation on long-term recovery outcome in first-episode psychosis--reply. JAMA Psychiatry 71, 208209.Google Scholar
15. Wunderink, L, Nieboer, RM, Wiersma, D, Sytema, SNienhuis, FJ (2013) Recovery in remitted first-episode psychosis at 7 years of follow-up of an early dose reduction/discontinuation or maintenance treatment strategy: long-term follow-up of a 2-year randomized clinical trial. JAMA Psychiatry 70, 913920.Google Scholar
16. Wunderink, L, Sytema, S, Nienhuis, FJWiersma, D (2009) Clinical recovery in first-episode psychosis. Schizophr Bull 35, 362369.Google Scholar
17. Fountoulakis, KN, Hoschl, C, Kasper, S, Lopez-Ibor, JMoller, HJ (2013) The media and intellectuals’ response to medical publications: the antidepressants’ case. Ann Gen Psychiatry 12, 11.Google Scholar
18. Jakobsen, JC, Katakam, KK, Schou, A, Hellmuth, SG, Stallknecht, SE, Leth-Moller, K, Iversen, M, Banke, MB, Petersen, IJ, Klingenberg, SL, Krogh, J, Ebert, SE, Timm, A, Lindschou, JGluud, C (2017) Selective serotonin reuptake inhibitors versus placebo in patients with major depressive disorder. A systematic review with meta-analysis and trial sequential analysis. BMC Psychiatry 17, 58.Google Scholar
19. Coyne, J (2016) Gøtzsche exaggerates benefits of psychotherapy for SMI while distorting data concerning psychotropic medication. Available at https://twitter.com/coyneoftherealm/status/750473515397111808. Accessed August 13, 2017.Google Scholar
20. Cipriani, A, Furukawa, TA, Salanti, G, Geddes, JR, Higgins, JP, Churchill, R, Watanabe, N, Nakagawa, A, Omori, IM, McGuire, H, Tansella, MBarbui, C (2009) Comparative efficacy and acceptability of 12 new-generation antidepressants: a multiple-treatments meta-analysis. Lancet 373, 746758.Google Scholar
21. Ioannidis, JP (2008) Effectiveness of antidepressants: an evidence myth constructed from a thousand randomized trials? Philos Ethics Humanit Med 3, 14.Google Scholar
22. Cipriani, A, Furukawa, TA, Salanti, G, Chaimani, A, Atkinson, LZ, Ogawa, Y, Leucht, S, Ruhe, HG, Turner, EH, Higgins, JPT, Egger, M, Takeshima, N, Hayasaka, Y, Imai, H, Shinohara, K, Tajika, A, Ioannidis, JPAGeddes, JR (2018) Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis. Lancet 391, 13571366.Google Scholar
23. Fountoulakis, KNMoller, HJ (2011) Efficacy of antidepressants: a re-analysis and re-interpretation of the Kirsch data. Int J Neuropsychopharmacol 14, 405412.Google Scholar
24. Fountoulakis, KN, Veroniki, AA, Siamouli, MMoller, HJ (2013) No role for initial severity on the efficacy of antidepressants: results of a multi-meta-analysis. Ann Gen Psychiatry 12, 26.Google Scholar
25. Kirsch, I, Deacon, BJ, Huedo-Medina, TB, Scoboria, A, Moore, TJJohnson, BT (2008) Initial severity and antidepressant benefits: a meta-analysis of data submitted to the Food and Drug Administration. PLoS Med 5, e45.Google Scholar
26. Bracken, PThomas, P (2001) Postpsychiatry: a new direction for mental health. BMJ 322, 724727.Google Scholar
27. Fountoulakis, KN (2016) Suicide and the economic situation in Europe: are we experiencing the development of a ‘reverse stigma’? Br J Psychiatry 209, 273274.Google Scholar
28. Campbell, P (1996) The history of the user movement in the United Kingdom. In: Heller J, Reynolds R, editors. Mental health matters: a reader. Basingstoke: Macmillan.Google Scholar
29. Double, DB (2001) Integrating critical psychiatry into psychiatric training. In: Newnes C, Holmes G, Dunn C, editors. This is madness too. Ross-on-Wye: PCCS Books.Google Scholar
30. Shaw, JBaker, M (2004) ’Expert patient’—dream or nightmare? BMJ 328, 723.Google Scholar
31. Cooper, D (1967) Psychiatry and anti-psychiatry. London: Tavistock Publications.Google Scholar