What is it about?

In British Columbia, clinicians are responsible for giving involuntary mental health patients information about their rights when they are admitted to the hospital. The Office of the Ombudsperson's investigation, published in 2019, found that patients were not consistently being told about their rights. One possible reason for this inconsistency is that there could be a conflict of interest: clinicians who think it's in a patient's best interest to stay in the hospital might not want to give the patient information that the patient could use to challenge their hospitalization. One of the Ombudsperson's recommendations was for the province to develop and implement a new service, independent of the hospital, that would give involuntary mental health patients information about their rights and help patients exercise those rights. In this study, the research team held focus groups with mental health clinicians, including nurses, social workers, occupational therapists, and others, who are responsible for giving patients rights information now and would have to work with providers of the independent rights advice service, if it is implemented. The research team asked the clinicians about how they felt about the possibility of an independent rights advice service. Clinicians' main concerns were that, with an external independent service, (a) patients may experience a delay in getting their rights information, (b) adding rights advisors might make an already chaotic admission process more complicated, and (c) more patients might challenge their hospitalization, leading to heavier administrative workload for clinical staff. But many clinicians believed that adding independent rights advisors would be positive. They would let focus on treatment and serve as a source of rights-related information for patients, families, and clinicians. Clinicians were comfortable with adding an independent rights service as long as their roles were clear. Clinicians would still be responsible for telling patients that they have rights, as soon as they are admitted. In other words, clinicians would still do rights notification. The independent rights advisors would give rights advice, which helps patients understand their rights and weigh their options based on their specific situations.

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Why is it important?

The province of British Columbia will develop and implement a new independent rights advice service. The service aims to help involuntary mental health patients understand their rights and exercise their rights, which can be an important part of supporting their autonomy and recovery. But because this service will have to work with clinicians who give mental health patients care, it's important to understand how clinicians feel about this change. Finding ways to support the clinicians' hopes for the service and to address their concerns can help the independent rights advice service and clinicians work together for the benefit of patients.

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This page is a summary of: A qualitative study of clinicians’ perspectives on independent rights advice for involuntary psychiatric patients in British Columbia, Canada, PLoS ONE, March 2021, PLOS,
DOI: 10.1371/journal.pone.0247268.
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