Involuntary psychiatric treatment and the erosion of consent: A critical discourse analysis of mental health legislation in British Columbia, Canada.

IF 1.9 4区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Health Pub Date : 2023-11-01 Epub Date: 2022-05-09 DOI:10.1177/13634593221096241

Maja Kolar, Colleen Varcoe, Helen Brown, Rochelle Einboden

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Abstract

The Mental Health Act (1996) is legislation that directs voluntary and involuntary psychiatric treatment for people experiencing mental health issues in British Columbia (BC), Canada. This critical discursive analysis explores how BC's Mental Health Act (1996) and the Guide to the Mental Health Act (2005) structure involuntary psychiatric treatment and illustrates how the discourses within these texts constitute people experiencing mental health issues as passive recipients of care. Understandings of people experiencing mental health issues as pathological, incapable, vulnerable and dangerous justify their need for protection and the protection of others. Protection is identified as a central legitimising discourse in the use of involuntary psychiatric treatment. Further, these texts define the roles and responsibilities of police, physicians and nurses in authorising and implementing involuntary psychiatric treatment. This analysis describes how this legislation erodes consent and entrenches social marginalisation. Alternatively, discourses of equity have potential to transform health care practices and structures that reproduce discourses of deficit, vulnerability and dangerousness, shifting towards promotion of the rights and safety of people experiencing mental health issues and crises.

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非自愿精神病治疗与同意的侵蚀：加拿大不列颠哥伦比亚省精神卫生立法的批判性话语分析。

《精神健康法》（1996年）是一项立法，指导加拿大不列颠哥伦比亚省经历精神健康问题的人进行自愿和非自愿的精神治疗。这一批判性话语分析探讨了不列颠哥伦比亚省的《心理健康法》（1996年）和《心理健康法案指南》（2005年）如何构建非自愿精神治疗，并说明了这些文本中的话语如何将经历心理健康问题的人视为被动的护理接受者。人们将经历心理健康问题的人理解为病态、无能、脆弱和危险，这证明了他们需要保护和保护他人。在非自愿精神治疗的使用中，保护被确定为一个核心的合法化话语。此外，这些文本规定了警察、医生和护士在授权和实施非自愿精神病治疗方面的作用和责任。该分析描述了这项立法如何侵蚀同意并巩固社会边缘化。或者，公平话语有可能改变医疗保健实践和结构，重现赤字、脆弱性和危险性话语，转向促进经历心理健康问题和危机的人的权利和安全。

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来源期刊

Health Multiple-

CiteScore

4.90

自引率

0.00%

发文量

期刊介绍： Health: is published four times per year and attempts in each number to offer a mix of articles that inform or that provoke debate. The readership of the journal is wide and drawn from different disciplines and from workers both inside and outside the health care professions. Widely abstracted, Health: ensures authors an extensive and informed readership for their work. It also seeks to offer authors as short a delay as possible between submission and publication. Most articles are reviewed within 4-6 weeks of submission and those accepted are published within a year of that decision.