Mental Health and Justice is a multi-disciplinary research initiative, funded by the Wellcome Trust, and addressing a cluster of public policy challenges that arise at the complex interface where mental health and mental healthcare interact with principles of human rights.
The principal aim of the project is to develop clinical, legal, and public policy strategies for jointly satisfying two fundamental imperatives: the imperative to protect people in contexts where they can be vulnerable, and the imperative to respect their agency and autonomy.
The Mental Health and Justice initiative takes place at a time of active reform in the area of mental health and mental capacity legislation, across the UK and around the world. This five-year project will support the reform agenda by undertaking research pertaining to two concepts that have been central to the reform movement: the concept of support in decision-making and the concept of decision-making ability.
The collaboration involves clinical experts, lawyers, philosophers, neuro-scientists, social scientists and service-users in a research network that will be delivering practical guidelines, enhancing policy engagement, and advancing interdisciplinary working and innovation in service-user involvement in research and public engagement.
Mental Health and Justice has six inter-related research strands:
Enabling Legal Capacity Through Decision-Making Support. Led by Dr Jill Craigie, this project will critically examine decision-making support as a strategy for jointly satisfying the two fundamental imperatives of protection and respect. It has a particular focus on intellectual disability and autism.
Support and Independence in the Community. Dr Hanna Kienzler leads this project using multi-site ethnography to explore the diverse meaning of (and barriers to) independence, community and support for persons with mental problems across socio-cultural contexts in Ghana, the occupied Palestinian territory, and England.
Supporting Advance Directives. Supported decision-making must be tailored to persons with diverse mental disorders in diverse socio-cultural contexts. This work, led by Dr Gareth Owen and Dr Tania Gergel, will focus on Bipolar Affective Disorder and the real-life implementation of advance directives as persons with Bipolar strive to provide guidance for their own treatment.
Insight. Professor Wayne Martin leads a project considering the role of ‘insight’ in mental health care, a key concept when it comes to treatment decisions. How can a person who lacks awareness that they are unwell competently assess treatment options for an illness they do not recognise, and what legal guidelines should frame decisions on coercive treatments?
Decision-making and Metacognition. This project will link decision-making ability to the related concept of metacognition and will use cognitive neuroscience methods to inform questions around decision-making ability and support. This research is led by Professor Anthony David.
Contested Assessment will consider the legal and clinical evidence that makes the assessment of decision-making capacity in a proportion of cases contested or hard. It aims to advance satisfactory resolutions and educational interventions. This research is led by Dr Gareth Owen and barrister/academic Alex Ruck Keene.
Mental Health & Justice is a unique collaboration based at King’s College London. It involves partnerships with the King’s Policy Institute, the University of Essex Autonomy Project, the McPin Foundation, the UK Ministry of Justice and Department of Health as well as international organisations such as the WHO in Geneva and NIH in the USA. Our public engagement partner is the Bethlem Gallery.