Least restrictive interventions towards consensus

Abstract

Background

Recommendation (2004) 10 Concerning the Protection of the Human Rights and Dignity of Persons with Mental Disorder binds member states of the Council of Europe to the principles of least restriction / least intrusiveness. There are however marked differences in how these principles are being interpreted in the context of coercive interventions across Europe. Current practice is the result of the emergence of national consensus on what is acceptable rather than evidence based with procedures banned in one country such as seclusion, in common use in another. In the light of moves towards greater European consensus on mental health issues more generally the absence of a European consensus is striking.

Aims

To identify how moves towards a consensus on the use of coercive interventions might be facilitated.

Methods

Literature review, discussion.

Results

The paper proposes a taxonomy of coercive interventions and critically examines the criteria that might be employed in determining what constitutes the least restrictive/least intrusive intervention in a given situation.

Conclusions

A pan-European consensus is possible but depends on better data collection across Europe on the use of coercive interventions in order to inform its development and a willingness by practitioners to critically reflect upon the cultural determinants of practice in their setting.