Going Public: A Clinic’s Call for Full Disclosure of Critical Mental Health Knowledge

Abstract

This chapter focuses on the helping professional’s responsibility to ensure client and community access to relevant critical mental health knowledge. Summarizing informed consent guidelines for Canadian psychologists, counsellors, and physicians, the chapter argues that conventional informed consent ethics may function to both support and suppress dissemination of critical mental health knowledge. The chapter features a community health clinic’s dialogic action research intended to address the lack of public access to critical mental health knowledge. The research enquires into the questions of if and how the clinic might systematically share its growing critical mental health knowledge with the client communities accessing clinic services. Description of the project’s dialogic process and research influences is followed by description of ten invitations to action emerging from the project dialogues. Continuing the clinic’s history of feminist resistance, the clinic’s research effort presents informed choice as a preferred ethical alternative to implied consent and informed consent ethics. The chapter will show how informed choice policies and practices change the nature, extent, timing, location, and purpose of critical mental health knowledge-sharing in everyday human services practice.

This research was supported by a Partnership Development Grant from the University of Winnipeg.

Appendices

Appendix A: Critical Mental Health Working Group Terms of Reference

Purpose:

The Critical Mental Health Working Group will review and make decisions on recommendations from the critical mental health dialogues, integrate actionable items into policy and practice at [name of clinic], and work to influence broader policies and practice.

Membership:

The committee is open to all staff and requires representatives from all sites and management. The committee will also require representation from:

• Medical practitioners

• Counselling Services

• PEDPRP

• Health Education

• Communications

• Mothers Program

Primary Objectives:

• To develop a position statement for the clinic

• To develop informed consent processes regarding mental health diagnosis

• To develop educational materials on the subject of mental health from a critical/feminist lens

• To review language used in programs and materials

• To develop a communications strategy for mental health messaging

Reporting and Accountability

The working group will report to Operations Committee.

Frequency

The working group will meet quarterly, or more or less frequently, as needed, determined by the chair and members.

Working Group Process

• The working group will be chaired by the counselling team leader or their designate.

• Minute-taking will be shared.

• These terms of reference will be reviewed yearly.

Appendix B: The [name of clinic] Mental Health Informed Choice Position Statement

• 1. Critical mental health research exposes misinformation, missing information, and potential for harm in mainstream mental health services.

• 2. Critical mental health scholarship includes intersectional feminist anti-oppression critique of mainstream mental health.

• 3. Informed choice means that clients will be provided with access to key outcomes from both conventional and critical mental health research.

• 4. Professional codes of ethics for Canadian physicians, psychologists, and counsellors have always required full disclosure of both benefits and risks relevant to client decision-making.

• 5. Wherever possible, psychiatric assessment and diagnosis will not take place without [name of clinic] clinic staff creating opportunity for explicit client informed choice.