The Essex Autonomy Project is currently involved in the following active research area:
Mental Health and Justice – Insight Project
Vital questions around insight and decision-making in clinical situations are being researched by the EAP as part of a research collaboration backed by the Wellcome Trust.
Leading clinical experts, lawyers, philosophers, neuroscientists and social scientists are being brought together through the Mental Health and Justice project to address the central dilemma in mental health, ethics and law – the tension between protecting and respecting a person’s decision-making. The five year project will focus on the two fundamental concepts – support in decision-making and decision-making ability – through the work of six integrated and collaborative projects.
The ability to make decisions for yourself, and to have them respected by others, is something that most adults take for granted. However, this ability may be limited by the presence of mental impairment and by society’s response to it. The challenge is to find the right balance between protection and respect in all the multitude of circumstances when the potential for conflict arises.
The research by the Essex Autonomy Project will consider the role of ‘insight’ in mental health care – a key concept when it comes to treatment decisions. Wayne Martin, lead investigator on the project explains why the work is important:
A person who shows awareness of the fact that they are unwell is described as having insight, whilst a person without that awareness is said to lack insight. A person with insight shares with clinicians a common ground on which discussion of diagnosis and treatment options can begin, but where insight is absent, that common ground is lacking leading to predictably lower treatment compliance and making coercive treatment more likely. From a clinician’s perspective, absence of insight can be a palpable reality, but from a legal perspective, the concept is fraught. Can someone competently assess treatment options for an illness whose existence they do not recognise?
The Decision-Making and Insight project will be led by Wayne, with contributions from Sabine Michalowski (School of Law at Essex) and Matt Burch (EAP).