Power Imbalances in Mental Health Care
In the attempt to make psychiatry a legitimate medical specialty diagnostic criteria were developed. In Canada, psychiatrists use DSM-5 diagnoses not just to organize, but also to justify treatment. In an era where we know about the importance of patients being active partners in their care, we must seek the input of our patients on their agreement or disagreement with diagnostic criteria. In practice, especially in the inpatient system where most people who are admitted are involuntary patients, the healthcare system maintains a culture of clinicians having power over patients. The imbalance of power sustains a system where clinicians, most prominently psychiatrists, are the ultimate decision-maker and nurses become stuck in a murky place of advocating for patients, exercising their own autonomy of holistic and person-centered care, while also acting on psychiatrists orders. The process continues to be a top-down approach despite attempts to embrace and implement collaborative ...