Informed Consent to Psychiatric Treatment for Depression in Shared Decision-Making

Within the context of psychiatric settings, this thesis explores the law in the United Kingdom in regulating doctor-patient relationships, specifically in the case of patients with depression.
Depression has now become a prevalent global mental health issue. In Western medical history, depression has long been medicalised and pharmaceutically treated as a mental illness. This thesis adopts a socio-legal approach to explore how depression is a biopsychosocial issue and how the law and policy should respond to social changes that influence the understanding of a person’s autonomy and mental capacity in psychiatric care. This thesis criticises the dehumanised, impoverished understanding of depression as an exclusively medical illness which necessarily needs medical treatment and risk intervention, and which, in a legal context, necessarily limits a person’s medical decision-making due to diminished autonomy. This thesis argues for a more humanised interpretation of patient autonomy in the healthcare delivery of depression to empower patients and promote patient autonomy through a collaborative and supportive doctor- patient relationship. In order to deliver this collaborative model, this thesis suggests: firstly, within the remit of the law, applying the Montgomery consent model in depression care; and secondly, beyond the remit of the law, using formulation as an alternative approach to replace psychiatric diagnosis. Those suggestions aim to contribute to new personalised psychiatric care, where the individual determinants of depression, both medical and social, can be explained and then addressed in each patient’s personal context.