Challenging contemporary mental health policy: time to assuage the coercion?
Bibliographic record
Abstract
BACKGROUND: In the United Kingdom (UK) and elsewhere throughout the world, the policy and legal frameworks that surround the provision of mental health care are becoming increasingly coercive. For example, emerging mental health policy in the UK includes a commitment to the introduction of compulsory treatment in the community. AIMS: In this paper, our aims are: to explore the context in which this more coercive mental health policy has arisen in the UK; to challenge the assumptions and the evidence that lie behind the introduction of proposed new mental health policies; and to consider the impact that a more coercive policy is likely to have on the practice of mental health nursing. DISCUSSION: In the UK, representatives of central government have declared that 'care in the community has failed'. This view has been reinforced by media representations of mental health issues. Policy documents have drawn attention to the risks posed by people with mental illnesses. Correspondingly, proposed initiatives emphasize the need to more closely 'manage' people with mental health problems, and set out a new legislative and policy framework to achieve this. We question the assumptions and evidence that underlie these planned new developments. We argue that, contrary to government assertions, there is no unequivocal evidence that 'community care' has failed. We observe, too, that people with mental health difficulties are often amongst the most vulnerable members of society. Finally, we consider the impact that a more coercive policy framework will have on the work of mental health nurses, and argue that the shift towards a more 'controlling' role is likely to run counter to what many nurses see as the 'core' of their work.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.068 | 0.115 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.015 | 0.089 |
| Scholarly communication | 0.034 | 0.035 |
| Open science | 0.005 | 0.016 |
| Research integrity | 0.037 | 0.043 |
| Insufficient payload (model declined to judge) | 0.009 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".