Coercion in Community Mental Health Care: International Perspectives

Front Cover
Andrew Molodynski, Jorun Rugkåsa, Tom Burns
Oxford University Press, 2016 - Medical - 358 pages
The use of coercion is one of the defining issues of mental health care. Since the earliest attempts to contain and treat the mentally ill, power imbalances have been evident and a cause of controversy. There has always been a delicate balance between respecting autonomy and ensuring that
those who most need treatment and support are provided with it.

Coercion in Community Mental Health Care: International Perspectives is an essential guide to the current coercive practices worldwide, both those founded in law and those 'informal' processes whose coerciveness remains contested. It does so from a variety of perspectives, drawing on diverse
disciplines such as history, law, sociology, anthropology and medicine to provide a comprehensive summary of the current debates in the field.

Edited by leading researchers in the field, Coercion in Community Mental Health Care: International Perspectives provides a unique discussion of this prominent issue in mental health. Divided into five sections covering origins and extent, evidence, experiences, context and international
perspectives this is ideal for mental health practitioners, social scientists, ethicists and legal professionals wishing to expand their knowledge of the subject area.


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1 Introduction
originsand extent
 historical developments and current provisions
3 Community treatment order legislation in the Commonwealth
Part 2 The evidence
4 Descriptive and epidemiological studies
5 Assessing the effectiveness of compulsory community treatment
 current evidence
 some sociological perspectives
13 Human rights in community psychiatry
14 The ethics of coercion in community mental health care
Part 5 International perspectives
15 Coercion in community mental health treatment in the Americas
16 Coercion and mental health services in the Indian subcontinent and the Middle East
17 Southeast Asia
18 Coercion in Europe

 where to for serviceuserled research?
Part 3 The experience
8 Coercion contextshow compliance is achieved in interaction
 universal meaning individual experiences?
10 Family carers and coercion in the community
11 Clinician attitudes experiences and use of coercion
Part 4 The context
 African perspectives
21 Regional themes
22 Conclusions

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About the author (2016)

Andrew Molodynski, Consultant Psychiatrist, Oxford Health NHS Foundation Trust, UK,Jorun Rugkasa, Senior Researcher, Health Services Research Unit, Akershus University Hospital, Lorenskog, Norway,Tom Burns, Professor Emeritus of Social Psychiatry, University of Oxford, Department of Psychiatry,
Warneford Hospital, UK

Andrew Molodynski is a Consultant Psychiatrist at Oxford Health NHS Foundation Trust and Honorary Clinical Senior Lecturer at Oxford University, UK. He has worked in community psychiatry for fifteen years and been actively involved in research in the field for ten. His recent research has primarily
focused on coercion in community mental health care but he has also published on social and occupational functioning in people with severe mental illness and on different forms of service provision. He has co- authored book chapters on assertive outreach and published a number of articles in
peer-reviewed journals. He is the chair of the World Association of Social Psychiatry international working group on coercion and coordinates their website which aims to provide education and links for interested parties.

Jorun Rugkasa is a Senior Researcher at the Health Services Research Unit, Akershus University Hospital, Norway. She is a Social Anthropologist and Sociologist with over 15 years' experience of health and health services research and is an author of more than 50 scientific papers and reports. Her
current research interests include treatment pressure, formal and informal coercion in community mental health services, personal experiences of coercion and the experiences of carers of people with mental health problems from ethnic minorities. In her role as Senior Researcher at the Department of
Psychiatry in Oxford she teaches socio-cultural factors in the aetiology of mental illness, culturally inclusive service responses and migration and mental health to medical students and psychiatrists.

Tom Burns is Professor Emeritus of Social Psychiatry at Oxford University. He worked as a psychiatrist in Scotland, Sweden, and London before moving to Oxford. His research is focused on interpersonal relationships in psychiatry and forms of care for patients with severe illnesses such as psychoses.
He has authored over 200 scientific papers and chapters and is the author or co-author of five books. He was awarded a CBE for services to mental health in 2006.

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