Avoiding a spiral of precaution in mental healthcare

Abstract

The precautionary principle has high face validity, but it can favour indeterminate future risks over potential current benefits. It can also have unintended consequences when applied to the design of clinical protocols and health policy. Contemporary pressures in mental healthcare may amplify the precautionary principle in practice. To mitigate against these disadvantages, we need trial designs that assess all risks (including the risk of no treatment) and also the possibility that potential risks may be successfully managed. Critical appraisal of clinical protocols and their impact are also necessary.