Convention on the rights of persons with disabilities in mental health. A human rights issue

2016 ◽  
Vol 9 (2) ◽  
pp. 126-127
Author(s):  
Sergio Ramos Pozón
Author(s):  
Marisha N. Wickremsinhe

AbstractGlobal mental health, as a field, has focused on both increasing access to mental health services and promoting human rights. Amidst many successes in engaging with and addressing various human rights violations affecting individuals living with psychosocial disabilities, one human rights challenge remains under-discussed: involuntary inpatient admission for psychiatric care. Global mental health ought to engage proactively with the debate on the ethics of involuntary admission and work to develop a clear position, for three reasons. Firstly, the field promotes models of mental healthcare that are likely to include involuntary admission. Secondly, the field aligns much of its human rights framework with the UN Convention on the Rights of Persons with Disabilities, which opposes the discriminatory use of involuntary admission on the basis of psychosocial disability or impairment. Finally, global mental health, as a field, is uniquely positioned to offer novel contributions to this long-standing debate in clinical ethics by collecting data and conducting analyses across settings. Global mental health should take up involuntary admission as a priority area of engagement, applying its own orientation toward research and advocacy in order to explore the dimensions of when, if ever, involuntary admission may be permissible. Such work stands to offer meaningful contributions to the challenge of involuntary admission.


2018 ◽  
Vol 27 (1) ◽  
pp. 10-13 ◽  
Author(s):  
Stephen Allison ◽  
Tarun Bastiampillai ◽  
Richard O’Reilly ◽  
Steven S Sharfstein ◽  
David Castle

Objective: There are increasing demands on emergency psychiatrists with higher numbers of mental health presentations, and longer stays in emergency departments (EDs). Australia, like other English speaking countries, funds considerably lower numbers of psychiatric beds than average for Organisation for Economic Co-operation and Development (OECD) countries. Consequently, acute bed occupancy is high, and a bed is frequently unavailable when a person needs admission. Patients with serious mental illness can wait days in busy and overstimulating EDs, become agitated and assaultive, and then require chemical and physical restraint. All patients have a right to safe high quality care, but the paucity of beds deprives patients of this right. The Australasian College of Emergency Medicine recommends reporting ED access block to health ministers, and human rights and/or health rights commissioners, and recommends increased funding for inpatient psychiatric care, emergency mental health and after-hours community services, together with more alcohol and other drug programs. Conclusions: It is challenging for emergency physicians and psychiatrists to provide optimal care for acutely unwell patients who stay extended periods in the ED. Increasing the availability of inpatient care must be considered as part of a comprehensive solution for minimising ED lengths of stay in Australia.


Author(s):  
Penelope Weller

Contemporary mental health laws are embedded in basic human rights principle, and their ongoing evolution is influenced by contemporary human rights discourse, international declarations and conventions, and the authoritative jurisprudence of the European Court of Human Rights (ECrtHR). The<em> Convention on the Rights of Persons with Disabilities</em> (CRPD) is the most recent expression of international human rights applicable to people with disability including people with mental illness.3 It provides a fresh benchmark against which to assess the human rights compatibility of domestic mental health laws.


Author(s):  
Oliver Lewis ◽  
Soumitra Pathare

This chapter sets out the connection between disability and human rights, examining how persons with disabilities (including those with physical disabilities, sensory disabilities, psychosocial or mental health disabilities, and intellectual disabilities) are particularly vulnerable to exclusion and discrimination, leading to human rights violations across the world. It has been a long global struggle to recognize the rights of people with disabilities and realize the highest attainable standard of physical, mental, and social well-being, a struggle evolving across countries and culminating in the 2006 adoption of the United Nations Convention on the Rights of Persons with Disabilities (CRPD). The provisions of the CRPD relate to three specific rights that are of particular importance to people with disabilities: legal capacity, the right to health, and the right to independent living. Yet, national implementation challenges remain, including finding space for mental health and disability in policymaking and developing models of service delivery that advance human rights.


2018 ◽  
Vol 16 (03) ◽  
pp. 68-70
Author(s):  
J. Maphisa Maphisa

The Mental Disorders Act of 1969 is the primary legislation relating to mental health in Botswana. Despite the country not being a signatory to the United Nations Convention on the Rights of Persons with Disabilities, its Act has a self-rated score of four out of five on compliance to human rights covenants. However, it can be argued that the Act does not adequately espouse a human rights- and patient-centred approach to legislation. It is hoped that ongoing efforts to revise the Act will address the limitations discussed in this article.


Author(s):  
Genevra Richardson

This chapter examines the increased concern for human rights within the global mental health policy agenda and considers what value human rights might add in relation to the use of coercion in community mental health. It describes the position underlying the European Convention on Human Rights (ECHR) and compares it with the more radical approach of the United Nations Convention on the Rights of Persons with Disabilities (CRPD). While the CRPD might be more challenging to mental health professionals, it contains within its principles that the wishes and preferences of the person be centre stage and as such deserve to be taken seriously in the provision of community mental health care.


2018 ◽  
Vol 63 (12) ◽  
pp. 809-812
Author(s):  
Mathieu Dufour ◽  
Thomas Hastings ◽  
Richard O’Reilly

The United Nations adopted the Convention on the Rights of Persons with Disabilities (CRPD) in 2006. When Canada ratified the CRPD, it reserved the right to continue using substitute decision making schemes even if the CRPD was ‘interpreted as requiring their elimination’. This was a prescient decision because the CRPD Committee, which is tasked with overseeing the interpretation and implementation of the CRPD, subsequently opined that all legislation supporting substitute decision making schemes contravene the CRPD and must be revoked. The CRPD Committee insists that every person can make decisions with sufficient support and that if a person lacks capacity to make a decision, we must rely on their ‘will and preferences’. Many international legal scholars have called this interpretation unrealistic. We agree and, in this article, describe how this unrealistic approach would result in extensive harm and suffering for people with severe cognitive or psychotic disorders. The reader should also be aware that the CRPD Committee also calls for the elimination of all mental health acts and the United Nations Commissioner for Human Rights for the abandonment of the not criminally responsible (NCR) defence.


2020 ◽  
Vol 46 (2) ◽  
pp. 231-235 ◽  
Author(s):  
George Szmukler

Abstract Recent challenges to conventional mental health laws concerning involuntary detention and treatment of persons with a mental disorder have led to proposals, or indeed an insistence, that fundamental reform is necessary. A key theme has been the need to eliminate unfair discrimination against people with a mental disorder because their human rights are not respected on an equal basis with other people. Some proposals depart radically from conventional assumptions concerning the justification of involuntary detention and treatment. One is a “fusion law,” a generic law applying to all persons lacking the ability to make a treatment decision, whether resulting from a “mental” or “physical” illness. An authoritative interpretation of the UN Convention on the Rights of Persons with Disabilities (2006) goes so far as to maintain that involuntary interventions are a violation of the Convention.


2016 ◽  
Vol 20 (2) ◽  
pp. 67-73
Author(s):  
Sue Holttum

Purpose – The purpose of this paper is to consider three recent papers relating to human rights and applicable to adults or children given mental health diagnoses. Design/methodology/approach – The first paper discussed how to measure progress in different countries in their policy changes to abide by the UN Convention on rights of persons with disabilities, and discussed how all relevant groups could be involved. The second paper considered the problem of children’s rights being eroded by overuse of the mental health diagnosis of attention deficit hyperactivity disorder (ADHD) when they are restless. The third paper reported on an evaluation of how well advocacy services are enabling people who are sectioned to have a say in their care. Findings – When assessing how well countries are doing in ensuring the rights of people with disabilities, the first paper’s authors concluded that all groups must participate in the evaluation, even though there are many different agendas. The second paper reported on how professionals and parents could come to a shared understanding of how children might be wrongly given a diagnosis of ADHD and jointly suggested some solutions. The third paper illustrated how important advocacy is, and the difference it can make to the lives of people who are sectioned. Originality/value – The first paper’s authors are engaged in ground-breaking research to assess whether disabled people’s rights under the UN Convention are being honoured. The second paper raised vital questions about the misuse of diagnosis, contravening the UN Convention on the rights of the child, and illustrated how parents and professionals can come together in support of these rights. The third paper reported on the first systematic national study on the implementation of advocacy services to defend the rights of people who are sectioned to have a say in their care.


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