Coercion in emergency mental health crises - what legal grounds, if any, justify it?

What is it about?

Currently, coercion in the psychiatric context is justified with reference to a person having a psychiatric diagnosis and posing a risk of harm to themselves of others. The CRPD establishes that this is discriminatory, as it only applies to people with a disability (and specifically people with a psychiatric diagnosis), and imposes a differential standard of rights upon them. In other words, rights to liberty, to bodily and mental integrity, to autonomy, consent in healthcare, are all held to a different standard. Some have called for a different threshold for emergency interventions in which decisions are 'made for' people in certain circumstances. Flynn and Gooding discuss whether the 'doctrine of necessity' might provide such a threshold without discriminating against people with disabilities. We explore what definitions of 'emergency' might create a non-discriminatory framework for respecting people's rights to be 'left alone', yet retaining scope to intervene in some emergency circumstances in ways that might otherwise constitute assault and deprivation of liberty.

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Why is it important?

The CRPD has posed major challenges to over a century of law and policy on mental distress, disorder and disablement. This paper explores the key issue of the seemingly bald discrimination inherent to mental health law, and explores alternative pathways. Rates of involuntary psychiatric intervention in places like the United Kingdom are increasing exponentially. Now is an urgent time to revisit questions about the fairness of mental health legislation.

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