Epilogue (Will-to-Hope)

The last chapter relates the main concerns of the book to what is fundamentally and existentially at stake in care through coercion, namely hope—the confidence that something is still possible. Mental illnesses, not least when involving involuntary admission to a psychiatric hospital and being subject to coercion, come with the risk of losing hope. Hence, it is paramount that health care professionals don’t lose hope, but sometimes they do, as both patients and their carers can be overtaken by the enemies of hope. Hence, this last leg of the book explores how both the pessimism of the public debate about mental health care and the optimism of the medical model can undermine hope, and how to enhance the ability to imagine a better future for the patient calls for compassionate realism and hope as a practical postulate. It requires a “facilitating environment” with a “holding capacity” for all the ambiguities intrinsic to mental health care practice involving the use of coercion—identified, elicited, and discussed in the preceding chapters of the book.