Self-binding directives, which allow people with mental illness to dictate a compulsory treatment for themselves in the event of a future episode, could give them a degree of control and safety in decision making, say Tania Gergel and Allen Frances . But Arun Chopra and Theo Van Willigenburg argue that this takes advance planning too far and could worsen inequalities
Many people with severe episodic mental illness, such as bipolar disorder, know from past experience that their illness may well expose them to risk during future severe episodes in a way that they won’t be able to control at that point. They may also recognise the likelihood that they’ll resist treatment during such episodes even though this is when treatment is most desperately needed.
These people understand, when they’re well, the potentially catastrophic consequences of remaining untreated, even including risk to their lives given the high risk of suicide, particularly during the most severe depressive or “m
Advocates say electroconvulsive therapy resets the brain, and studies suggest it helps stave off severe depression where other options fail: in the UK it s given 20,000 times a year.
From The Lancet: If electroconvulsive therapy is so very effective and so very safe, why is it used only by a tiny and dwindling number of psychiatrists?