This report provides a compendium of good practices to promote voluntary measures in mental health care and support. It draws from practices submitted to the DH-BIO Secretariat by delegations representing the 47 Member States of the Council of Europe (COE) as well as civil society stakeholders. The compendium fulfils the aim set out in the DH-BIO Strategic Action Plan on Human Rights and Technologies in Biomedicine 2020-2025 to:

assist member States [by developing] a compendium of good practices to promote voluntary measures in mental healthcare, both at a preventive level and in situations of crisis, by focusing on examples in member States.

 

The practices may directly aim to reduce, prevent, or even eliminate coercive practices in mental health settings, and others will indirectly result in similar outcomes by advancing the general aim to promote voluntary mental health care and support.

The compendium is not meant as an exhaustive list of leading practices in COE Member States. Instead, it is meant as an initial step toward compiling practices aimed at promoting voluntary mental healthcare and support, and reducing and preventing coercion in mental health settings. More generally, the materials promote compliance with the Convention on the Rights of Persons with Disabilities (CRPD), notwithstanding debates about coercion in mental healthcare which will be noted in Part 1(B) of the report.

Back Family Group Conferencing – The Netherlands

Family Group Conferencing is a ‘“family-driven” decision-making model and social network strategy’ (Schout, Meijer, et al., 2017). In the Netherlands, where it was developed for the mental health context, a Family Group Conference is called an Eigen Kracht-conference. This translation emphasises the essence of this practice: using the strength and resources of people to make a plan and make decisions for the future and thus directing their own lives. According to Mental Health Europe:

The underlying idea is very simple. If you have problems in your life that cannot be easily solved, you ask your social network to think things over with you. Everyone has a social network – large or small, close or less close – regardless of what happened in the past. Most people solve their problems or concerns this way. But when people have become isolated and think that no one cares about them anymore, or when they are too ashamed to turn to their own people, an Eigen Kracht-conference may be the answer. An independent coordinator will help them to organize an Eigen Kracht-conference. (Submission 28)

Family Group Conferencing is a voluntary consultation process, adapted from a Māori-led process for resolving family court disputes, in which an independent co-ordinator facilitates a series of discussions between an individual and her or his key social network. The individual selects friends and/or family, or professionals, to discuss issues of concern and seek solutions, including composing a plan which sets out the steps to be taken.

The role of the co-ordinator is to think 'with' the group, help remove barriers to participation, and seek consensus. Clinicians may have a background support role, or could have a role in facilitating any outcomes of decisions that involve clinical care. Meijer and colleagues (2017) conducted a study involving 41 family group conferences in three Dutch regions. Using survey and observation to identify the impact of the practice on coercive treatment in adult psychiatry, the authors concluded that family group conferencing 'seems a promising intervention to reduce coercion in psychiatry' by helping to 'regain ownership and restore[] belongingness' (Meijer et al, 2017, p.1862). (For more information, see Eigen Kracht website; see also De Jong & Schout, 2010; Schout, Meijer, et al., 2017; Schout, van Dijk, et al., 2017)).

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