Implications of the RADAR trial: the dignity of risk taking

Recovery-oriented psychiatry: oxymoron or catalyst for change?

This Personal View provides a normative and conceptual analysis of the intersection between the recovery movement and psychiatry. Although recovery emerged as a grassroots social justice movement emphasising empowerment and systemic change, psychiatry remains rooted in the medical paradigm. We aim to develop a nuanced conceptual framework that fosters academic debate and meaningful implementation, while avoiding superficial or tokenistic adoption of recovery principles. Our analysis explores the contrasting values, ontologies, and epistemologies of these perspectives, identifying points of tension and areas of compatibility. We examine and discuss integrative and non-integrative pluralistic approaches, and we conclude with actionable recommendations for transformation at different organisational levels.

When Shared Decision-Making Breaks Down: Solving Moral Dilemmas in Antipsychotic Deprescribing

ABSTRACT

Many individuals diagnosed with psychosis make multiple attempts to discontinue antipsychotic medications. In this clinical challenge, we examine three snapshots in which shared decision-making (SDM) breaks down due to ongoing disagreement between the service user and the health care provider. We offer three perspectives on how to think about such disagreement: philosophical, psychological, and psychiatric perspectives. Finally, we propose shared deliberation as a potential model for when SDM fails, emphasizing an iterative process of mutual value sharing that avoids binary yes/no responses.