The Consumer Movement and Compulsory Treatment: A Professional Outlook

Compulsory treatment is a controversial issue in psychiatry. In the last several decades consumer groups have repeatedly and clearly stood up against compulsory treatment and forced medication, although their positions include important diversities both in philosophical conceptualizations and practical consequences. This article reviews this issue through the eyes of professionals, highlighting aspects related to the consumer movement's radical wing and to the efforts toward negotiations of other groups. Issues arising from the debate between consumers and professionals are analyzed and strategies to overcome compulsory treatment are examined, with special reference to the psychiatric advance directives. The article stresses that compulsory treatment debate should be framed within the larger context of a public health approach and to the present state of mental health services. The article also considers the importance of the reflexive loop between what is offered by services and what is refused by consumers. Finally, the need to incorporate a variety of contributions outside a narrow medical model is outlined