Since there is potential for harm in mental health services (Timimi, 2017), we want to inform and empower you in your care. Informed choice is unfortunately rare in the field of mental health. Clients, patients, and the public rarely hear about these issues (Johnstone et al., 2018). We do not want anybody to not benefit from or be harmed by their diagnosis or treatment.
The ethical responsibility for informed consent rests with your healthcare provider (Canadian Medical Association, 2018; Canadian Psychological Association, 2017). It is common for healthcare providers to use an “implied consent” standard of care for mental disorder assessment and diagnosis (DeFehr, 2020). This means the provider assumes a client asking for their professional opinion is the same thing as consent. Implied consent has not been sufficient to prevent people from feeling misled.
A power balance exists between a healthcare provider and the client/patient. This can make it challenging to talk to them about your concerns. It becomes more challenging for marginalized groups who find they are not understood or listened to.
Healthcare providers intend to help the people they serve. Unfortunately, many are not aware of the potentials for harm or may not consider the impact of the power imbalance.
It is also rarely considered that a mental disorder diagnosis has potential for harm all on its own. Our hope is to raise awareness of these issues and advocate for a higher standard of care.
If the areas we have highlighted are concerns for you, the best course of action is to educate yourself. It is important to know about these issues before you talk to your healthcare provider.
You can ask your doctor to delay a diagnosis until you have had a chance to look at your choices, however, not every provider will agree to this. If you want to decline a diagnosis entirely, you can talk to your healthcare provider about your concerns and see if they are able to assist you without one — this may or may not be possible.
Accessing help is also possible outside of the field of medicine.
There are many ways of approaching the problems we call mental health. There are choices available to work with these problems with or without prescription drugs, such as:
- Finding social support
- Connecting to loved ones
- Connecting to community, culture, or spirituality
- Accessing counselling, therapy, or groups
- Talking to trusted people in your life or community
- Learning more about your own wellbeing and the problems you’re experiencing
- Learning to respond helpfully to your needs
- Making decisions and acting on areas that are problems in your life
- Committing to taking care of yourself in multiple ways
