Occupational aspects in decision-making by (former) users of Mental Health and Psychiatric Services regarding psychopharmacological treatment

Abstract

Introduction: In Chile, the regulations on Mental Health and Psychiatry (MH&P) are out of alignment with the provisions of international law. In this context, in 2021 law 21,331 was approved, which recognizes the right to autonomy in decision-making regarding treatments. Based on evidence of the barriers that users encounter when making decisions in the context of MH&P in Chile, the occupational justice framework is proposed as a tool to support decision-making and in line with the Rights Framework promoted by international organizations. Objective: Recognize occupational aspects in the narratives of users and former users of the MH&P services that led them to make decisions regarding psychopharmacological treatment (PPT). Method: Through semi-structured interviews and field notes, six narratives were developed with users and former users of MH&P services in Chile in 2022. These were subjected to thematic and structural analysis. Results: In the narratives, occupation appears as a key element in the decision-making process regarding the PPT, both to initiate it and to leave it or modify it. Moreover, occupation is a means of reconstruction and transformation towards desired states. Conclusion: Occupational aspects are relevant in decision-making regarding the PPT. The occupational justice framework can be a tool to visualize social and political situations that affect participation, whenever the contexts in which it applies are considered.