Skip to main content Accessibility help
×
Hostname: page-component-7c8c6479df-7qhmt Total loading time: 0 Render date: 2024-03-29T08:23:02.026Z Has data issue: false hasContentIssue false

25 - Users’ Involvement in Decision-Making: Lessons from Primary Research in India and Japan

Published online by Cambridge University Press:  20 August 2021

Michael Ashley Stein
Affiliation:
Harvard Law School
Faraaz Mahomed
Affiliation:
Wits University
Vikram Patel
Affiliation:
Harvard Medical School
Charlene Sunkel
Affiliation:
Global Mental Health Peer Network
Get access

Summary

People with psychosocial disabilities experience substituted decision-making, including involuntary admission, regularly. The Convention on the Rights of Persons with Disabilities (CRPD) mandates States parties to respect the will, preference, and autonomy of the person at all times. However, implementing this at policy and practice level in each country is still controversial. To explore will, preference, and autonomy of people with psychosocial disabilities, this chapter aims to understand the types of contexts and relationships service users were engaged in leading up to their participation in admission decision-making. Service users who previously had been involuntarily admitted designed and carried out interviews at psychiatric hospitals in Japan and India. The interviews showed that service users were marginalized through power imbalances and a lack of communication. Service users were discouraged from nurturing autonomy in their everyday lives leading up to admission decision-making. Based on the study, we recommended policies that would give service users the same powers as other stakeholders and encourage open communication between them. Implementing these policies into their everyday lives would enable them to confidently voice their will and preference at the admission decision-making stage, including making direct decisions or effectively using supported decision-making.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77101. https://doi.org/10.1191/1478088706qp063oaGoogle Scholar
Dove, E. S., Kelly, S. E., Lucivero, F., et al. (2017). Beyond individualism: Is there a place for relational autonomy in clinical practice and research? Clinical Ethics, 12(3), 150165. https://doi.org/10.1177/1477750917704156Google Scholar
Freeman, M. C., Kolappa, K., de Almeida, J. M. C., et al. (2015). Reversing hard won victories in the name of human rights: A critique of the General Comment on Article 12 of the UN Convention on the Rights of Persons with Disabilities. The Lancet Psychiatry, 2(9), 844850. https://doi.org/10.1016/S2215-0366(15)00218-7Google Scholar
Kong, C. (2015). The Convention for the Rights of Persons with Disabilities and Article 12: Prospective feminist lessons against the “will and preferences” paradigm. Laws, 4(4), 709728. https://doi.org/10.3390/laws4040709Google Scholar
Ministry of Health, Labour and Welfare, Government of Japan (1950). Act on Mental Health and Welfare for the Mentally Disabled. www.japaneselawtranslation.go.jp/law/detail_main?re=&vm=2&id=3480Google Scholar
Ministry of Law and Justice, Legislative Department, Government of India (1987). Mental Health Act 1987. https://legislative.gov.in/actsofparliamentfromtheyear/mental-health-act-1987Google Scholar
Ministry of Law and Justice, Legislative Department, Government of India (2017). Mental Healthcare Act, 2017. www.prsindia.org/uploads/media/Mental Health/Mental Healthcare Act, 2017.pdfGoogle Scholar
Sugiura, K., Mahomed, F., Saxena, S., & Patel, V. (2020). An end to coercion: Rights and decision-making in mental health care. Bulletin of the World Health Organization, 98(1), 5258. https://doi.org/10.2471/BLT.19.234906Google Scholar
United Nations. (2007). Convention on the rights of persons with disabilities. UN Doc. A/61/611 (2006).Google Scholar
von Peter, S., Aderhold, V., Cubellis, L., et al. (2019). Open Dialogue as a human rights-aligned approach. Frontiers in Psychiatry, 10 (May), 16. https://doi.org/10.3389/fpsyt.2019.00387Google Scholar
Walter, J. K., & Ross, L. F. (2014). Relational Autonomy: Moving beyond the limits of isolated individualism. Pediatrics, 133 (Supplement), S16S23. https://doi.org/10.1542/peds.2013-3608DGoogle Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×