Bringing together the World Health Organization's QualityRights initiative and the World Psychiatric Association's programme on implementing alternatives to coercion in mental healthcare: a common goal for action.

BACKGROUND: Stakeholders worldwide increasingly acknowledge the need to address coercive practices in mental healthcare. Options have been described and evaluated in several countries, as noted recently in major policy documents from the World Health Organization (WHO) and World Psychiatric Association (WPA). The WHO's QualityRights initiative promotes human rights and quality of care for persons with mental health conditions and psychosocial disabilities. A position statement from the WPA calls for implementation of alternatives to coercion in mental healthcare. AIMS: We describe the engagement of both the WHO and WPA in this work. We discuss their mutual aim to support countries in improving human rights and quality of care, as well as the differences between these two organisations in their stated goals related to coercion in mental healthcare: the WHO's approach to eliminate coercion and the WPA's goal to implement alternatives to coercion. METHOD: We outline and critically analyse the common ground between the two organisations, which endorse a similar range of rights-based approaches to promoting non-coercive practices in service provision, including early intervention in prevention and care and other policy and practice changes. RESULTS: Advocacy and action based on an agreed need to find practical solutions and advances in this area have the power to build consensus and unify key actors. CONCLUSIONS: We conclude that persons with lived experience, families, mental health professionals and policy makers are now coming together in several parts of the world to work toward the common goals of improving quality, promoting human rights and addressing coercion in mental health services.

Comparison of coercive practices in worldwide mental healthcare: overcoming difficulties resulting from variations in monitoring strategies.

BACKGROUND: Coercive or restrictive practices such as compulsory admission, involuntary medication, seclusion and restraint impinge on individual autonomy. International consensus mandates reduction or elimination of restrictive practices in mental healthcare. To achieve this requires knowledge of the extent of these practices. AIMS: We determined rates of coercive practices and compared them across countries. METHOD: We identified nine country- or region-wide data-sets of rates and durations of restrictive practices in Australia, England, Germany, Ireland, Japan, New Zealand, The Netherlands, the USA and Wales. We compared the data-sets with each other and with mental healthcare indicators in World Health Organization and Organisation for Economic Cooperation and Development reports. RESULTS: The types and definitions of reported coercive practices varied considerably. Reported rates were highly variable, poorly reported and tracked using a diverse array of measures. However, we were able to combine duration measures to examine numbers of restrictive practices per year per 100 000 population for each country. The rates and durations of seclusion and restraint differed by factors of more than 100 between countries, with Japan showing a particularly high number of restraints. CONCLUSIONS: We recommend a common set of international measures, so that finer comparisons within and between countries can be made, and monitoring of trends to see whether alternatives to restraint are successful. These measurements should include information about the total numbers, durations and rates of coercive measures. We urge the World Health Organization to include these measures in their Mental Health Atlas.

Wide-angle seismic reflections reveal a lithosphere-asthenosphere boundary zone in the subducting Pacific Plate, New Zealand.

New wide-angle seismic reflection data from offshore New Zealand show that the lithosphere-asthenosphere boundary (LAB) is more structured than previously thought. Three distinct layers are interpreted within a 10- to 12-km-thick LAB zone beginning at a depth of ≈70 km: a 3 (±1)-km-thick layer at the bottom of the lithosphere with a P-wave (VP) azimuthal anisotropy of 14 to 17% and fast azimuth subparallel to the direction of absolute plate motion and a 9 (±2)-km-thick, low VP channel with a P-wave-to-S-wave velocity ratio (VP/VS) of >2.8 in the upper 7 km of the channel and 1.8 to 2.6 in the lower 2 km of the channel. The high VP/VS ratios indicate that this channel may contain 3 to 20% partial melt that facilitates decoupling of the lithosphere from the asthenosphere and reduces resistance for plate motion. Furthermore, the strong azimuthal anisotropy above the low-velocity layer suggests localization of strain due to melt accumulation.

Segmentation of Shallow Slow Slip Events at the Hikurangi Subduction Zone Explained by Along-Strike Changes in Fault Geometry and Plate Convergence Rates.

Over the last two decades, geodetic and seismic observations have revealed a spectrum of slow earthquakes along the Hikurangi subduction zone in New Zealand. Of those, shallow slow slip events (SSEs) that occur at depths of less than 15 km along the plate interface show a strong along-strike segmentation in their recurrence intervals, which vary from ∼1 yr from offshore Tolaga Bay in the northeast to ∼5 yr offshore Cape Turnagain ∼300 km to the southwest. To understand the factors that control this segmentation, we conduct numerical simulations of SSEs incorporating laboratory-derived rate-and-state friction laws with both planar and non-planar fault geometries. We find that a relatively simple model assuming a realistic non-planar fault geometry reproduces the characteristics of shallow SSEs as constrained by geodetic observations. Our preferred model captures the magnitudes and durations of SSEs, as well as the northward decrease of their recurrence intervals. Our results indicate that the segmentation of SSE recurrence intervals is favored by along-strike changes in both the plate convergence rate and the downdip width of the SSE source region. Modeled SSEs with longer recurrence intervals concentrate in the southern part of the fault (offshore Cape Turnagain), where the plate convergence rate is lowest and the source region of SSEs is widest due to the shallower slab dip angle. Notably, the observed segmentation of shallow SSEs cannot be reproduced with a simple planar fault model, which indicates that a realistic plate interface is an important factor to account for in modeling SSEs.

Seismic anisotropy beneath Ruapehu volcano: a possible eruption forecasting tool.

The orientation of crustal seismic anisotropy changed at least twice by up to 80 degrees because of volcanic eruptions at Ruapehu Volcano, New Zealand. These changes provide the basis for a new monitoring technique and possibly for future midterm eruption forecasting at volcanoes. The fast anisotropic direction was measured during three seismometer deployments in 1994, 1998, and 2002, providing an in situ measurement of the stress in the crust under the volcano. The stress direction changed because of an eruption in 1995-1996. Our 2002 measurements revealed a partial return to the pre-eruption stress state. These changes were probably caused by repeated filling and depressurizing of a magmatic dike system.