idem, a short term experience of the self, and the ipse, a longer term persistent experience of the self. In mental illness, the autonomy of the ipse can be undermined by the autonomy of the idem, so involuntary mental health treatment can trade one form of autonomy for another. Sociology Medical sociology seeks to understand the social processes underlying decisions made in medicine. Sociologist Jeremy Dixon, speaking in the context of the United Kingdom, argues that assessment and monitoring of risk is a core part of mental health practice but that this risk is often in conflict with broadly-defined goals of recovery including living a satisfying life. He argues that this focus on risk causes mental health professionals to make decisions defensively based on reputational damage if there were to be any inquiry and that multidisciplinary approaches are used for this purpose. He cites research showing how mental health professionals may seek to shift the burden of responsibility onto individuals themselves (noting different clinical decisions for those with personality disorders compared to those with psychotic disorders because they are viewed as more responsible for their behaviours), or shift responsibility onto other public health services. Risk assessments themselves are rarely shared with patients. Proponents and detractors Proponents Supporters of involuntary treatment include organizations such as the National Alliance on Mental Illness (NAMI), the American Psychiatric Association, and the Treatment Advocacy Center. Detractors A number of civil and human rights activists, anti-psychiatry groups, medical and academic organizations, researchers, and members of the psychiatric survivors movement vigorously oppose involuntary treatment on human rights grounds or on grounds of effectiveness and medical appropriateness, particularly with respect to involuntary administration of mind altering substances, ECT, and psychosurgery. Some criticism has been made regarding cost, as well as of conflicts of interest with the pharmaceutical industry. Critics, such as the New York Civil Liberties Union, have denounced the strong racial and socioeconomic biases in forced treatment orders. Special rapporteurs of the United Nations (Catalina Devandas Aguilar and Dainius Puras) consider it as an infringement of the dignity of those subjected to it, with severe consequences for their physical and mental integrity and call on concerned states to put an end to respect individual's autonomy. Involuntary treatment is compared to torture on at least two special reports of the UN, one noting "forced psychiatric interventions, when committed against persons with psychosocial disabilities, satisfies both intent and purpose