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Mental health disabilities and human rights protections

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      Abstract

      Background.

      Around the world, reports regularly expose persistent and systemic human rights violations of patients in mental health services and facilities, and of those who are unable to access needed supports. A number of factors contribute – political will; the range and quality of services available; public and professional attitudes to mental health; stigma; health professionals’ training and expertise; and available resources.

      Methods.

      This paper examines one of the main determinants, the legal framework. This sets the parameters for mental health policies and services and for applicable human rights norms and standards that can be realized in practice.

      Results.

      We provide an overview of international human rights instruments in relation to mental health disabilities, and of the major human rights violations in this area. Key implications for mental health law reform are drawn with a particular focus on discrimination and coercive interventions. The major challenges posed by the UN Convention on the Rights of Persons with Disabilities (2006) are examined. Current mental health laws, to greater or lesser degrees, fail to meet the newly required standards. We discuss reforms based on ‘generic law’ and ‘legal capacity’ principles that seek to meet those standards.

      Conclusions.

      We outline some emergent and promising examples of reform. The role of civil society and the importance of the standing of those with mental health disabilities in this process is noted.

      Related collections

      Most cited references 16

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      Global pattern of experienced and anticipated discrimination against people with schizophrenia: a cross-sectional survey.

      Many people with schizophrenia experience stigma caused by other people's knowledge, attitudes, and behaviour; this can lead to impoverishment, social marginalisation, and low quality of life. We aimed to describe the nature, direction, and severity of anticipated and experienced discrimination reported by people with schizophrenia. We did a cross-sectional survey in 27 countries, in centres affiliated to the INDIGO Research Network, by use of face-to-face interviews with 732 participants with schizophrenia. Discrimination was measured with the newly validated discrimination and stigma scale (DISC), which produces three subscores: positive experienced discrimination; negative experienced discrimination; and anticipated discrimination. Negative discrimination was experienced by 344 (47%) of 729 participants in making or keeping friends, by 315 (43%) of 728 from family members, by 209 (29%) of 724 in finding a job, 215 (29%) of 730 in keeping a job, and by 196 (27%) of 724 in intimate or sexual relationships. Positive experienced discrimination was rare. Anticipated discrimination affected 469 (64%) in applying for work, training, or education and 402 (55%) looking for a close relationship; 526 (72%) felt the need to conceal their diagnosis. Over a third of participants anticipated discrimination for job seeking and close personal relationships when no discrimination was experienced. Rates of both anticipated and experienced discrimination are consistently high across countries among people with mental illness. Measures such as disability discrimination laws might, therefore, not be effective without interventions to improve self-esteem of people with mental illness.
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        Human rights violations of people with mental and psychosocial disabilities: an unresolved global crisis.

        This report reviews the evidence for the types of human rights violations experienced by people with mental and psychosocial disabilities in low-income and middle-income countries as well as strategies to prevent these violations and promote human rights in line with the UN Convention on the Rights of Persons with Disabilities (CRPD). The article draws on the views, expertise, and experience of 51 people with mental and psychosocial disabilities from 18 low-income and middle-income countries as well as a review of English language literature including from UN publications, non-governmental organisation reports, press reports, and the academic literature. Copyright © 2011 Elsevier Ltd. All rights reserved.
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          Elements of a Theory of Human Rights

           Amartya Sen (2004)
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            Author and article information

            Affiliations
            [1 ]Institute of Psychiatry , King's College London, UK
            [2 ]IRIS – Institute for Research and Development on Inclusion and Society, Kinsmen Building, York University , North York, Ontario, Canada
            Author notes
            [* ]Address for correspondence: G. Szmukler, Institute of Psychiatry , De Crespigny Park, London SE5 8AF, UK. (Email: george.szmukler@ 123456kcl.ac.uk )
            Journal
            Glob Ment Health (Camb)
            Glob Ment Health (Camb)
            GMH
            Global Mental Health
            Cambridge University Press (Cambridge, UK )
            2054-4251
            2015
            1 October 2015
            : 2
            5269623 10.1017/gmh.2015.18 S2054425115000187 00018
            © The Author(s) 2015

            This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence ( http://creativecommons.org/licenses/by/3.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

            Counts
            References: 24, Pages: 9
            Product
            Categories
            Policy and Systems
            Original Research Paper
            WHO Action Plan

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