Open Forum

Choice has become a buzzword. Everyone from policymakers to grass roots activists is talking about choice and few people would disagree with the principle. But perhaps it is time to question whether we actually mean choice, or whether we mean something entirely different that is dressed up as choice.

For me, choice is about having the information and resources to make a decision based on having several viable options.

Many people would argue that, as all choices have consequences, the fact that some choices are based on equally difficult options does not take away from the fact that a choice has been offered. Professionals can then pat themselves on the back because they have offered service users a choice.

This is a dangerous road to go down because it is all too easy to mask coercion as a choice.

For example, with four professionals sitting in my home I was told I had the choice to accept the input of the home treatment service or be detained under the Mental Health Act 1983. Every time I tried to disagree with what the professionals wanted, I was told I had a choice but if I refused to accept their decisions I would be sectioned. Such a situation cannot be described as a choice.

Coercion was the top and bottom of it. It would have been more palatable and honest if the professionals involved had said that they had sufficient concerns and they needed to manage any isk, that they were not offering a choice, that the decision-making power was to be taken away from me.

Throughout social care there are times when professionals have to make difficult decisions. Risk management, gatekeeping and a multitude of other situations can mean that professionals retain control of decisions and actions and may sometimes have to resort to coercion. I am sure that, although it may be a bitter pill to swallow, lots of service users understand this. All we ask for is honesty and not a false idea of choice.  

Nasa Begum is a user of mental health services

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