A rejection of involuntary treatment in mental health social work

Social work has long taken a pragmatic approach to involuntary mental health treatment, attempting to reconcile social work values and ethics with the perceived need for involuntary treatment. This paper draws on developments in law, psychiatry, psychology and sociology to challenge this acceptance and social work’s implicit support of involuntary treatment. Mental health social work is shown to be characterised by neoliberal influences of risk management and conservative professionalism. The implications of the Convention on the Rights of Persons with Disabilities are examined to highlight the discrimination inherent in involuntary treatment on the basis of diagnosis, and to demonstrate the importance of adopting an approach of supported, not substituted, decision-making. The right to choose treatment is suggested as a guiding principle for rethinking mental health service provision. Contemporary research on risk management is presented to challenge the justification of involuntary treatment as a means to manage dangerousness, and the ascendant recovery approach is shown to be incompatible with coercion in involuntary treatment. Finally, social workers are encouraged to consider theoretical and practical alternatives in the new paradigm of mental health social work which rejects involuntary treatment.