Mental Health Research Through Clinical Innovation or Quality Improvement – A Reflection on the Ethical Aspects

When clinical services aspire to quality improvement, creative and innovative approaches to old problems are needed to drive such change. Whilst new eff orts should be applauded, information on this topic can be somewhat grey from an ethical and research point of view. Within the mental health profession there is currently an expectation to routinely evaluate care and disseminate fi ndings. The notion of service enhancements under the guise of routine practice is an interesting and untested ethical issue. Should clinical innovation continue to enjoy such impunity as patient autonomy is often compromised as they are often compelled to accept treatment under the coercion of mental health legislation? We believe that it should not. All involvement in any form of research is voluntary, thus patients should also have the right to decline participation in quality projects if they wish to do so.