Human rights in community psychiatry

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 16 (02) ◽  
pp. 37-40 ◽  
Author(s):  
Julian Eaton

Globally, established practice in mental health services has tended to be codified into law in ways that are paternalistic, seeking to make decisions for patients that presume ‘best interest’ and which ultimately place power in the hands of medical authority. The United Nations Convention on the Rights of Persons with Disabilities (CRPD) – which has been widely ratified globally – challenges these assumptions, instead placing the expressed will and preference of patients as the most important factor in decision-making, including treatment and consent to admission. The contradictions between these approaches cause profound challenges in legislation reform, but a human rights framework offers the potential for a paradigm shift in the way that people are treated in services, and in exploration of alternative practices that promise a more humane and dignified future for mental health care.


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.


2021 ◽  
Vol 194 ◽  
pp. 531-680

531Human rights — Rights of women in Northern Ireland — Pregnant women and girls — Autonomy and bodily integrity — Right to respect for private and family life — Rights of persons with disabilities — Right not to be subjected to torture or inhuman or degrading treatment or punishment — Abortion law in Northern Ireland — Prohibition on abortion in cases of serious malformation of foetus, rape and incest — Balancing of rights — Whether moral and political issues relevant — Role of courts and Parliament — Whether abortion law incompatible with Articles 3 and 8 of European Convention on Human Rights, 1950 — Whether declaration of incompatibility should be madeHuman rights — Right to respect for private and family life — Qualified right — Abortion law in Northern Ireland — Prohibition on abortion in cases of serious malformation of foetus, rape and incest — Interference with right to respect for private and family life under Article 8 of European Convention on Human Rights, 1950 — Whether interference justified — Whether interference prescribed by law — Whether having legitimate aim — Whether necessary in democratic society — Whether proportionate — In case of fatal foetal abnormality — In case of rape — In case of incest — In case of serious foetal abnormality — Balancing of rights — European Court of Human Rights — Margin of appreciation accorded to United Kingdom represented by Northern Ireland Assembly — Whether legislative situation in Northern Ireland tenable — Role of legislature and courts — Whether Northern Ireland abortion law incompatible with Article 8 of European Convention on Human Rights, 1950 — Whether declaration of incompatibility should be madeHuman rights — Rights of persons with disabilities — Treaties — United Nations Convention on the Rights of Persons with Disabilities, 2006 — Northern Ireland abortion law prohibiting abortion in cases of serious malformation of the foetus — Foetus having potential to develop into child with disability in cases of serious foetal abnormality — Value of life with and without disability — Whether life having equal worth — United Nations Committee on the Rights of Persons with Disabilities recommending States amend abortion laws so as to value equally the life of a person with disabilities — Whether Northern Ireland abortion law disproportionate in cases of serious foetal abnormality — Whether abortion law in Northern Ireland incompatible with Article 8 of European Convention on Human Rights, 1950 — Whether declaration of incompatibility should be made532Human rights — Right not to be subjected to torture or inhuman or degrading treatment or punishment — Article 3 of European Convention on Human Rights, 1950 — Rights of girls and women in Northern Ireland pregnant with foetuses with fatal abnormality or due to rape or incest — Article 3 absolute right — Effect on victim — Whether mothers continuing against their will with fatal foetal abnormality pregnancies or pregnancies due to rape or incest, or having to travel to England for an abortion, likely to suffer inhuman and degrading treatment — Whether any ill-treatment under Article 3 reaching minimum level of severity — Obligations owed by the State under Article 3 of European Convention — Vulnerability of women — Personal autonomy — Whether abortion law in Northern Ireland incompatible with Article 3 of European Convention — Whether declaration of incompatibility should be madeRelationship of international law and municipal law — Treaties — Implementation — Interpretation — Effect in domestic law — International treaties to which United Kingdom a party — European Convention on Human Rights, 1950 — Human Rights Act 1998 — United Nations Convention on the Elimination of All Forms of Discrimination against Women, 1979 — United Nations Convention on the Rights of Persons with Disabilities, 2006 — Whether moral and political issues relevant — Balancing of rights — Northern Ireland abortion law interfering with right under Article 8 of European Convention on Human Rights, 1950 — Whether interference justified — Whether prescribed by law — Whether having legitimate aim — Whether necessary in democratic society — Whether proportionate — Relevance of moral and political views — Role of courts and Parliament in abortion debate — Whether pregnant women and girls subjected to inhuman or degrading treatment — Whether reaching minimum level of severity for breach of Article 3 of European Convention — Whether Northern Ireland abortion law incompatible with Articles 3 and 8 of European Convention on Human Rights, 1950 Convention — Whether declaration of incompatibility should be madeRelationship of international law and municipal law — Treaties — European Convention on Human Rights, 1950 — Effect in domestic law — Abortion law in Northern Ireland — Sections 58 and 59 of the Offences against the Person Act 1861 — Section 25(1) of the Criminal Justice Act (NI) 1945 — Right to respect for private and family life — Right not to be subjected to torture or inhuman or degrading treatment or punishment — Whether abortion law in 533Northern Ireland incompatible with Article 8 of European Convention — Balancing of rights — Whether abortion law justified — Whether moral and political values relevant — Margin of appreciation accorded to States by European Court of Human Rights — Whether abortion law in Northern Ireland incompatible with Articles 3 and 8 of European Convention — Whether declaration of incompatibility should be madeTreaties — Interpretation — Implementation — Application — Effect in domestic law — European Convention on Human Rights, 1950 — Interpreting European Convention in light of other international treaties to which United Kingdom a party — United Nations Convention on the Elimination of All Forms of Discrimination against Women, 1979 — United Nations Convention on the Rights of Persons with Disabilities, 2006 — Relevance of unincorporated international treaties when applying European Convention via Human Rights Act 1998 — The law of the United Kingdom


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.


2013 ◽  
Vol 41 (1) ◽  
pp. 48-73 ◽  
Author(s):  
Sheila Wildeman

The World Health Organization (WHO) has in the last decade identified mental health as a priority for global health promotion and international development, to be targeted through promulgation of evidence-based medical practices, health systems reform, and respect for human rights. Yet these overlapping strategies are marked by tensions as the historical primacy of expert-led initiatives is increasingly subject to challenge by new social movements — in particular, disabled persons’ organizations (DPOs). These tensions come into focus upon situating the WHO’s contributions to the analysis of global mental health in light of the negotiation and early stages of implementation of the Convention on the Rights of Persons with Disabilities (CRPD), particularly as it applies to persons with mental disabilities.


2018 ◽  
Vol 7 (2) ◽  
pp. 199-224 ◽  
Author(s):  
Andrea Broderick

The traditional dichotomy of rights between civil and political rights, on the one hand, and economic, social and cultural rights, on the other hand, has been increasingly eroded in scholarly and judicial discourse. The interdependence of the two sets of rights is a fundamental tenet of international human rights law. Nowhere is this interdependence more evident than in the context of the United Nations Convention on the Rights of Persons with Disabilities (CRPD or UN Convention). This article examines the indivisibility and interdependence of rights in the CRPD and, specifically, the positive obligations imposed on States Parties to the UN Convention, in particular the reasonable accommodation duty. The aim of the paper is to analyse, from a disability perspective, the approach adopted by the European Court of Human Rights (ECtHR or ‘Strasbourg Court’) in developing the social dimension of certain civil and political rights in the European Convention on Human Rights (ECHR), namely Articles 2 and 3 (on the right to life and the prohibition on torture, inhuman and degrading treatment, respectively), Article 8 (on the right to private and family life) and Article 14 ECHR (on non-discrimination). Ultimately, this paper examines the influence of the CRPD on the interpretation by the Strasbourg Court of the rights of persons with disabilities under the ECHR. It argues that, while the Court is building some bridges to the CRPD, the incremental and often fragmented approach adopted by the Court could be moulded into a more principled approach, guided by the CRPD.


2021 ◽  
Vol 52 (1) ◽  
pp. 221-244
Author(s):  
Toni Wharehoka

This article argues the New Zealand Government's current approach to compulsory psychiatric treatment is unjustifiable in a human rights context. Under s 59 of the Mental Health (Compulsory Assessment and Treatment) Act 1992, clinicians are empowered to administer compulsory psychiatric treatment to individuals without, or contrary to, their consent. This article analyses s 59, and its underlying justifications, in light of the New Zealand Government's commitments under the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD). Further, it analyses the approach for compulsory psychiatric treatment advocated by the UNCRPD in light of Aotearoa New Zealand's mental health context to evaluate whether this approach would be more desirable than the current approach under s 59. The article then advocates for a more balanced approach to compulsory psychatric treatment which puts the rights of disabled individuals at the forefront and also ensures there are limits to these rights which are justifiable within a human rights context.


Author(s):  
Crick Lund ◽  
Dörte Bemme ◽  
Judy Bass

Global mental health has emerged in recent years as a field of research, advocacy, and practice that is concerned with improving the mental health of populations and reducing inequity in the global burden of mental illness. Because these challenges are multi-faceted, global mental health has been marked from its inception as a multi-disciplinary field, incorporating disciplines of psychiatry, psychology, epidemiology, health economics, anthropology, and implementation science. This chapter provides an overview of the emerging and dynamic field of global mental health. It starts with a brief history of the field, noting landmark publications and events. The chapter then introduces key areas of enquiry and action in global mental health, including epidemiology, mental health policy and services, intervention research, implementation science, qualitative research, instrument development, and economic evaluation. Finally, it concludes with reflections on critiques of the field and future directions.


2007 ◽  
Vol 89 (867) ◽  
pp. 505-514

AbstractDr Abdel Hamid Afana, MA, PhD, is the President of the International Rehabilitation Council for Torture Victims, Director of the Training and Research Department at the Gaza Community Mental Health Programme, a non-governmental organization established in 1990 which adopts a community-based approach to tackle mental health problems, and President of the Board of Directors of the Jesoor Organization that deals with community rehabilitation for trauma and human rights abuse victims. He is a psychotherapist, a graduate of the University of Oslo in Norway, and has extensive experience in torture rehabilitation. Dr Afana is one of the scholars who believe that mental health and human rights are inseparable and that mental health professionals have a role in community development and building bridges for peace through health. He is the founder and former head of the international board of a postgraduate diploma in Community Mental Health and Human Rights and a member of national, regional and international organizations and professional bodies in fields related to health and human rights. Through transcultural psychiatry at McGill University, Dr Afana is analyzing the social representation, meaning of and means of coping with traumatic experiences in protracted conflicts.


2021 ◽  
Vol 58 (2) ◽  
pp. 147-156
Author(s):  
Rachel Kronick ◽  
G. Eric Jarvis ◽  
Laurence J. Kirmayer

This article introduces a thematic issue of Transcultural Psychiatry that presents recent work that deepens our understanding of the refugee experience—from the forces of displacement, through the trajectory of migration, to the challenges of resettlement. Mental health research on refugees and asylum seekers has burgeoned over the past two decades with epidemiological studies, accounts of the lived experience, new conceptual frameworks, and advances in understanding of effective treatment and intervention. However, there are substantial gaps in available research, and important ethical and methodological challenges. These include: the need to adopt decolonizing, participatory methods that amplify refugee voices; the further development of frameworks for studying the broad impacts of forced migration that go beyond posttraumatic stress disorder; and more translational research informed by longitudinal studies of the course of refugee adaptation. Keeping a human rights advocacy perspective front and center will allow researchers to work in collaborative ways with both refugee communities and receiving societies to develop innovative mental health policy and practice to meet the urgent need for a global response to the challenge of forced migration, which is likely to grow dramatically in the coming years as a result of the impacts of climate change.


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