Flourishing, Mental Health Professionals and the Role of Normative Dialogue

Hazem Zohny; Julian Savulescu; Gin S Malhi; Ilina Singh

doi:10.1007/s10728-023-00478-4

Flourishing, Mental Health Professionals and the Role of Normative Dialogue

Health Care Anal. 2024 Jan 12. doi: 10.1007/s10728-023-00478-4. Online ahead of print.

Authors

Hazem Zohny^{1

2

3}, Julian Savulescu^{4

5

6

7

8}, Gin S Malhi^{9

10

11

12}, Ilina Singh^{2

3}

Affiliations

¹ Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK.
² Department of Psychiatry, University of Oxford, Oxford, UK.
³ Wellcome Centre for Ethics and Humanities, University of Oxford, Oxford, UK.
⁴ Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK. jsavules@nus.edu.sg.
⁵ Wellcome Centre for Ethics and Humanities, University of Oxford, Oxford, UK. jsavules@nus.edu.sg.
⁶ Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Queenstown, Singapore. jsavules@nus.edu.sg.
⁷ Murdoch Children's Research Institute, Melbourne, Australia. jsavules@nus.edu.sg.
⁸ University of Melbourne, Melbourne, Australia. jsavules@nus.edu.sg.
⁹ Academic Department of Psychiatry, Kolling Institute, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
¹⁰ CADE Clinic and Mood-T, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia.
¹¹ Visiting Professor, Department of Psychiatry, University of Oxford, Oxford, Australia.
¹² Oxford Uehiro Centre for Practical Ethics, Faculty of Philosophy, University of Oxford, Oxford, Australia.

PMID: 38214808
DOI: 10.1007/s10728-023-00478-4

Abstract

This paper explores the dilemma faced by mental healthcare professionals in balancing treatment of mental disorders with promoting patient well-being and flourishing. With growing calls for a more explicit focus on patient flourishing in mental healthcare, we address two inter-related challenges: the lack of consensus on defining positive mental health and flourishing, and how professionals should respond to patients with controversial views on what is good for them. We discuss the relationship dynamics between healthcare providers and patients, proposing that 'liberal' approaches can provide a pragmatic framework to address disagreements about well-being in the context of flourishing-oriented mental healthcare. We acknowledge the criticisms of these approaches, including the potential for unintended paternalism and distrust. To mitigate these risks, we conclude by suggesting a mechanism to minimize the likelihood of unintended paternalism and foster patient trust.

Keywords: Flourishing; Liberal approaches; Mental healthcare; Patient well-being; Shared-decision making; Values-based practice.

Grants and funding

WT203132/Z/16/Z/WT_/Wellcome Trust/United Kingdom