Is there place for informed consent in treatment of psychotic patients? A reflection on treatments of psychosis

Abstract

Informed consent (IC) in Mental Health care is unusual, especially for psychotic patients. However, current legislation, statements of professional associations, patient organizations and deontological codes advocate informed consent and patients' autonomy, also for people with psychosis. Patients and their relatives usually are unaware of the scope, limits and risks of drug treatment and the existence of other approaches.

The reasons for the IC’s lack can be found in the peculiarities of these patients, but also on the assumption that psychosis impacts the core of the person, and therefore they are unfit of understanding and consent.

Today there are two different ways to receive the patient with psychosis problems: first, the mainstream whose objective is to block the process and reverse psychotic symptoms principally using antipsychotics drugs, and another one, that includes various clinic models, that receive psychotic person with their difficulties, proposing to build a framework of understanding for their experiences. The outcomes don’t reveal superiority for the mainstream model, rather the opposite.

When listening to the users, they clearly opt for their autonomy and right to choose, rejecting coercive models.

Informed consent is a right that empowers the patients and also a recovery factor for many of them.

Its implementation will require significant changes in the training of professionals and in the current Mental Health Care networks.