Wickremsinhe Marisha N
Ethox Centre and Wellcome Centre for Ethics and Humanities, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Int J Ment Health Syst. 2021 Mar 2;15(1):20. doi: 10.1186/s13033-021-00448-0.
Global mental health, as a field, has focused on both increasing access to mental health services and promoting human rights. Amidst many successes in engaging with and addressing various human rights violations affecting individuals living with psychosocial disabilities, one human rights challenge remains under-discussed: involuntary inpatient admission for psychiatric care. Global mental health ought to engage proactively with the debate on the ethics of involuntary admission and work to develop a clear position, for three reasons. Firstly, the field promotes models of mental healthcare that are likely to include involuntary admission. Secondly, the field aligns much of its human rights framework with the UN Convention on the Rights of Persons with Disabilities, which opposes the discriminatory use of involuntary admission on the basis of psychosocial disability or impairment. Finally, global mental health, as a field, is uniquely positioned to offer novel contributions to this long-standing debate in clinical ethics by collecting data and conducting analyses across settings. Global mental health should take up involuntary admission as a priority area of engagement, applying its own orientation toward research and advocacy in order to explore the dimensions of when, if ever, involuntary admission may be permissible. Such work stands to offer meaningful contributions to the challenge of involuntary admission.
作为一个领域，全球精神卫生既关注增加精神卫生服务的可及性，也关注促进人权。在应对和处理影响心理社会残疾者的各种侵犯人权行为方面取得诸多成功的同时，有一项人权挑战仍未得到充分讨论：精神科护理的非自愿住院治疗。全球精神卫生应当积极参与关于非自愿住院治疗伦理的辩论，并努力形成明确立场，原因有三。其一，该领域所倡导的精神卫生保健模式可能包括非自愿住院治疗。其二，该领域的许多人权框架与《联合国残疾人权利公约》相一致，该公约反对基于心理社会残疾或损伤而歧视性地使用非自愿住院治疗。最后，全球精神卫生作为一个领域，凭借跨环境收集数据和进行分析，在为临床伦理这一长期辩论提供新颖贡献方面具有独特优势。全球精神卫生应将非自愿住院治疗作为一个优先参与领域，运用自身的研究和宣传导向，以探讨非自愿住院治疗在何时（如果有的话）可能是允许的。此类工作有望为非自愿住院治疗这一挑战做出有意义的贡献。
