TREATMENT CONSIDERATIONS FOR WOMEN PSYCHIATRIC PATIENTS Donna E Stewart, MD, FRCPC University Profess...
INTERNATIONAL CONSENSUSSTATEMENT ON WOMEN’S MENTAL HEALTHApproved WPA General Assembly Cairo 2005 ...
WOMEN’S MENTAL HEALTH• WHO: Can only be understood by considering the biological, social, cultural, economic and persona...
CONTEXT• Women’s Mental health must be considered within the context of women’s lives, and cannot be achieved without ac...
CONSENSUS• Mental health a critical aspect of public health• Health promotion, prevention, policy• Social, economic, cultu...
Positive women’s mental health benefits the health of women themselves, their families, and the general population, ...
TREATMENT• The setting for care should be nonstigmatizing and within their economic means, by adequately skilled health ...
• Women’s preferences for informed medical decision making should be respected whenever possible• Quality of care should...
• Appropriate services for adolescent, peripartum, midlife, older, immigrant, refugee, disabled and incarcerated women ...
RECOMMENDATIONSAppropriate governmental,nongovernmental, health and internationalorganizations should integrate girls’ and...
1. Support psychological health promotion programs that encompass the life context of girls and women to include equal...
3. Support public education and awareness campaigns that increase recognition and reduce the stigma of mental illness in...
5. Support timely access to adequately skilled mental health professionals who provide quality of care consistent with b...
7.Support the provision of accurate information and respect choices in treatment decision making by girls and women whe...
10. Support the provision of core training and education about gender issues for health, and mental health, professi...
UNITED NATION’S INSTRUMENTS RELEVANT TO M.H• Protection of Persons with Mental Illness• Protection and Promotion ...
INTERNATIONAL ORGANIZATION & REGIONAL INSTRUMENTS• WPA – Declaration of Madrid and following… - Consensus Statem...
PROTECTION OF PERSONS WITH MENTAL ILLNESS and THE IMPROVEMENT OF MENTAL HEALTH CARE http://www...
• 1.1 right to best available care• 1.2 treated with humanity and respect *• 1.3 protection from exploitation, abuse and ...
• 8.1 right to received care appropriate to health needs• 8.2 protection from harm• 9.3 in accordance with applicable sta...
• 11.1 no treatment without informed consent• 11.4 right to refuse treatment• 11.12 sterilization never carried out as tr...
UN CONVENTION ON THE RIGHTS OF PERSONS WITH DISABILITIES ADOPTED 2006, FORCE 2008• Sets out legal obligations on st...
GENERAL PRINCIPLES• Respect for inherent dignity , autonomy and independence• Nondiscrimination• Full and effective parti...
RIGHTS• Freedom from exploitation, violence and abuse• Respect for privacy• Right to health care• Right to work• Right to...
CONCLUSIONS• There are special issues for women psychiatric patients• Power/autonomy/informed consent issues• Respect/mod...
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Ponencia iawmh donna stewart

Published on: Mar 4, 2016
Source: www.slideshare.net


Transcripts - Ponencia iawmh donna stewart

  • 1. TREATMENT CONSIDERATIONS FOR WOMEN PSYCHIATRIC PATIENTS Donna E Stewart, MD, FRCPC University Professor and Chair of Women’s Health, Senior Scientist, University Health Network, University of Toronto, Canada
  • 2. INTERNATIONAL CONSENSUSSTATEMENT ON WOMEN’S MENTAL HEALTHApproved WPA General Assembly Cairo 2005 World Psychiatry 2006;5: 61-64
  • 3. WOMEN’S MENTAL HEALTH• WHO: Can only be understood by considering the biological, social, cultural, economic and personal context of their lives• WFMH 1996: “Psychological distress for women often has social origins. Discrimination against women in employment, education, food, healthcare, and resources for economic development, renders them vulnerable to physical and sexual violence, psychiatric disorders and psychological distress.”
  • 4. CONTEXT• Women’s Mental health must be considered within the context of women’s lives, and cannot be achieved without access to basic human rights: - autonomy of the person, education, safety, economic security, property and legal rights, employment, physical health, including sexual and reproductive rights, access to health care, adequate food, water and shelter
  • 5. CONSENSUS• Mental health a critical aspect of public health• Health promotion, prevention, policy• Social, economic, cultural aspects as well as biological• Focus on broad determinants of mental health• Education is the key to empowerment: schools are vital• Primary health care sites for MH promotion, ID, Rx• MH information and services available for all groups• Strong gender perspectives to guide multidisciplinary teams and stakeholders• Only by societal attitude shifts will women realize their full potential and MH
  • 6. Positive women’s mental health benefits the health of women themselves, their families, and the general population, and promotes women’s participation in professions and leadership
  • 7. TREATMENT• The setting for care should be nonstigmatizing and within their economic means, by adequately skilled health professionals with access to appropriate treatments• Treatment settings should be safe, and free from breaches of fiduciary trust by health care providers and staff
  • 8. • Women’s preferences for informed medical decision making should be respected whenever possible• Quality of care should be assessed by indicators that are consistent with best current knowledge, informed by gender- sensitive research• Women who have been sexually abused, or who have strong preferences for female health care providers, should be accommodated whenever possible
  • 9. • Appropriate services for adolescent, peripartum, midlife, older, immigrant, refugee, disabled and incarcerated women are essential• Acute and continuing care, supportive and rehabilitative mental health services across the life span are essential to enable mentally ill women to achieve their optimal level of functioning and wellbeing
  • 10. RECOMMENDATIONSAppropriate governmental,nongovernmental, health and internationalorganizations should integrate girls’ andwomen’s mental health as a priority inpolicy and program development and:
  • 11. 1. Support psychological health promotion programs that encompass the life context of girls and women to include equal access to basic human rights, education and employment, the elimination of violence and discrimination and the reduction of poverty2. Support women’s marital, sexual and reproductive choices and ensure access to safe motherhood
  • 12. 3. Support public education and awareness campaigns that increase recognition and reduce the stigma of mental illness in girls and women4. Support safe, respectful, appropriate, gender sensitive comprehensive mental health and physical health services for girls and women across the life cycle irrespective of the economic and social status, race, nationality or ethnocultural background
  • 13. 5. Support timely access to adequately skilled mental health professionals who provide quality of care consistent with best current knowledge and availability of appropriate therapy, technology or drugs and who take women’s special needs into consideration6.Support the development and use of culturally appropriate diagnostic systems that consider the sociocultural context of women’s lives, and biological differences when they are salient
  • 14. 7.Support the provision of accurate information and respect choices in treatment decision making by girls and women whenever possible8.Support the provision of mental health care for girls and women that is free from breaches in fiduciary responsibility9.Support increased attention to research on girls’ and women’s mental health including those factors which enhance or inhibit the development of resiliency
  • 15. 10. Support the provision of core training and education about gender issues for health, and mental health, professionals11. Support gender equality in practice and promotion within mental health services and organizations including equal opportunities for advancement and eradication of gender harassment, intimidation or unjustified discrimination on the basis of sex.
  • 16. UNITED NATION’S INSTRUMENTS RELEVANT TO M.H• Protection of Persons with Mental Illness• Protection and Promotion of Rights and Dignity of Persons with Disabilities• Declaration of Human Rights• Economic, Social, Cultural Rights• Civil and Political Rights• Against Torture, Cruelty, Degrading Treatment
  • 17. INTERNATIONAL ORGANIZATION & REGIONAL INSTRUMENTS• WPA – Declaration of Madrid and following… - Consensus Statements – on Women’s Mental Health & VAW• African Charter on Human Rights• Interamerican Convention on Human Rights• European Convention on Human Rights• Council of Europe Recommendations on Psychiatry and Human Rights
  • 18. PROTECTION OF PERSONS WITH MENTAL ILLNESS and THE IMPROVEMENT OF MENTAL HEALTH CARE http://www.un-document.net/a46r119.htmOffice of UN High Commissioner for Human Rights Dec. 1991, Adopted by General Assembly
  • 19. • 1.1 right to best available care• 1.2 treated with humanity and respect *• 1.3 protection from exploitation, abuse and degrading treatment *• 4.3 family, professional, moral or cultural conflicts never a determining factor in diagnosis
  • 20. • 8.1 right to received care appropriate to health needs• 8.2 protection from harm• 9.3 in accordance with applicable standards of ethics• 9.4 directed towards enhancing personal autonomy
  • 21. • 11.1 no treatment without informed consent• 11.4 right to refuse treatment• 11.12 sterilization never carried out as treatment• 13.2 living conditions close to those of normal life• 13.4 labour of patient never be exploited• 19.1 entitled to access to own health and personal records• 20.2 right to receive best available care
  • 22. UN CONVENTION ON THE RIGHTS OF PERSONS WITH DISABILITIES ADOPTED 2006, FORCE 2008• Sets out legal obligations on states to promote and protect the rights of persons with disabilities• Article 1: Includes those with long term physical, mental, intellectual or sensory impairments which in interaction with various barriers may hinder full and effective participation in society on an equal basis with others
  • 23. GENERAL PRINCIPLES• Respect for inherent dignity , autonomy and independence• Nondiscrimination• Full and effective participation in society• Respect for differences and acceptance of persons• Equity between men and women• Accessibility to health services• ----• ----
  • 24. RIGHTS• Freedom from exploitation, violence and abuse• Respect for privacy• Right to health care• Right to work• Right to adequate standard of living
  • 25. CONCLUSIONS• There are special issues for women psychiatric patients• Power/autonomy/informed consent issues• Respect/modesty issues• Sexual abuse issues (staff and patients)• Safety issues• Access to appropriate/sensitive care• Needs education, policy, more training

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