UEMS Section of Psychiatry Advocates for Human Rights and Recovery in Coercive Practices

November 2023

The UEMS Section of Psychiatry Human Rights Working Group, has published a Position Paper addressing the critical issue of maintaining human rights and recovery principles when coercive practices are considered in psychiatric treatment.

Ensuring Human Rights and Recovery Principles

The paper emphasises the necessity of aligning psychiatric practices and training with fundamental human rights and recovery principles. Coercive practices, defined as non-consensual treatments or interventions, must be approached as a last resort, subject to rigorous scrutiny, and alternatives should always be sought.

The paper acknowledges the challenging situations where coercive practices may be unavoidable due to extreme risks or cases of severe mental illness. However, it stresses the importance of strictly adhering to relevant and protective legislation to safeguard individuals' fundamental rights.

Educating Psychiatrists for Change

To address this complex issue, the UEMS Section of Psychiatry advocates for comprehensive education in key areas, including human rights, medical ethics, informed consent, and a holistic bio-psycho-social approach to mental disorders. Psychiatrists should be equipped with the knowledge of international laws, such as the UN Convention on the Rights of Persons with Disabilities (CRPD), and be trained in evidence-based interventions to reduce or eliminate coercive measures.

A Call for Systemic Change

The paper stresses the need for a holistic, recovery-focused approach to reduce coercive practices. Psychiatrists should be skilled in conflict resolution, de-escalation, and emotional regulation. The creation of a welcoming environment, free from potential triggers of aggression, is vital.

Moreover, the Section advocates for the use of evidence-based interventions, such as de-escalation techniques, comfort rooms, crisis intervention teams, advance directives, and individualised plans to identify and manage triggers. A systemic change at the institutional level is crucial for the successful reduction of coercive measures.

Involving Stakeholders for Change

The Section underscores the importance of involving all stakeholders, including people with lived experiences, their families, health systems, communities, and legislators, in changing policies and implementing evidence-based practices.

Appendix: Recovery Principles

The paper concludes with an appendix outlining recovery principles, highlighting the importance of hope, person-driven pathways, identity, holistic approaches, cultural sensitivity, strengths, and responsibilities, relationships, trauma-informed care, and more.

The UEMS Section of Psychiatry encourages continued dialogue, collaboration, and action to ensure that psychiatric practices align with human rights and recovery principles, fostering a culture of respect and optimism for those facing mental health challenges.

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