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The concept of citizenship incorporates the belief in equal rights for every individual regardless of their circumstances to access civil, political, social and economic opportunities. It is particularly important for people with mental health problems to enjoy the same rights and social justice as all citizens and to be protected from laws; social exclusion; institutional service and treatment practices that segregate or discriminate in any form or kind.
Cultural Diversity and Values
In many countries in the world people from diverse ethnic backgrounds have struggled with being treated as different to the rest of the community. This has a significant impact on peoples wellbing and mental health. In Western countries people from black and minority communities are over respresentative in services and it is acknowledged by policy makers and providers as an issue of concern.
Specifically, more people from diverse ethnic backgrounds are diagnosed as having a mental health disorder for emotional and mental distress, furthermore they are being diagnosed with serious mental illnesses more than the rest of the population. In some countries, particularly the UK, people from these backgrounds are being compulsory treated and to stay longer in hospital than the rest of the population.
Instead of people from diverse ethnic backgrounds being stigmatised and treated differently they should be valued for the diversity and richness they bring to society. All people having an impact on an individual’s wellbeing should be aware of their own perceptions, assumptions and prejudices particularly when making judgements and assessments of an individual’s mental health status.
There is much to be learned in the world from cultures, ways of life and the ways people are included of people in every aspect of a community life. For example there are many countires in the developing world with greater recovery rates from serious mental health conditions in comparison with European and Western countries. The evidence from international longitudinal studies need to be taken into account by service users, family members, policy makers and providers.
Respect and Dignity
Every person has the right to be treated with respect and dignity and it is essential that this is common practice by professionals, organisations and the public. Being treated with respect and dignity enhances people’s feeling that they are worthwhile and are valued, useful and important as fellow human beings. This will lead to the person gaining confidence in their self worth, self respect, ability and contribution to society.
Challenging discrimination and abuses of human rights
All over the world there is still widespread stigma about mental health and towards people with mental health problems
This can take various forms;
- complete isolation from the community
- laws that discriminate and exclude people
- suppression and denial by families
- institutional services and practices
- violation of basic human right
- physical and psychological abuse
This stigma and belief system has its origins in how society chose, 200 years ago, to deal with people that they thought were very different from the “rest’ of society. Consequently, this has dictated the nature of the legal response, service provision, clinical practice, this in turn has perpetuated stigma and the social exclusion of people with mental health problems.
Whilst there has been some worthy exceptions to this, they are few in number, compared to the general situation throughout the world.
The IMHCN is committed to work with others to continue to fight all forms stigma and to promote actions and solutions to overcome them.
Some of the actions that can be taken to reduce the misunderstanding and misconceptions of society are:
- No restrictions in life for people with mental health problems in society through laws that discriminate
- Developing educational programs in schools, colleges and universities and vocational learning
- Promoting positive messages and stories of good mental health and recovery to all forms of media (including journalists, TV and Radio producers, online platforms etc)
- Organising effective, consistent and regular anti discrimination and positive identity campaigns within local communities
- Developing publications and other media (e.g videos and audio) to educate the public empowering and enabling carers and users to share their own stories
- Advocating and campaigning for legislation to protect the rights of users.
- Educating professionals on how to interpret correctly the implementation of mental health laws to the maximum benefit of people with mental health problems.
Mental health service providers also need to play their part in challenging practices and services that perpetuate stigma and discrimination.
Some essential targets for action include:
- Reducing and ending locked facilities in acute in-patient settings
- No physical or chemical restraint
- Reducing compulsory admissions and treatments
- Reducing the need and use of specialised forensic services
- Reducing the lengths of stay in acute in-patient and other settings
In this section you will find a comprehensive set of publications, research and practice papers, links and other resources that will assist you and your organisation in promoting human and civil rights.
Mental Health and Human Rights: Vision, praxis, and courage (2012) Michael Dudley (Editor), Derrick Silove (Editor), Fran Gale (Editor), OUP Oxford
Mental disorders are ubiquitous, profoundly disabling and people suffering from them frequently endure the worst conditions of life.
In recent decades both mental health and human rights have emerged as areas of practice, inquiry, national policy-making and shared international concern. Human-rights monitoring and reporting are core features of public administration in most countries, and human rights law has burgeoned. Mental health also enjoys a new dignity in scholarship, international discussions and programs, mass-media coverage and political debate. Today's experts insist that it impacts on every aspect of health and human well-being, and so becomes essential to achieving human rights.
It is remarkable however that the struggle for human rights over the past two centuries largely bypassed the plight of those with mental disabilities. Mental health is frequently absent from routine health and social policy-making and research, and from many global health initiatives, for example, the Millenium Development Goals. Yet the impact of mental disorder is profound, not least when combined with poverty, mass trauma and social disruption, as in many poorer countries. Stigma is widespread and mental disorders frequently go unnoticed and untreated. Even in settings where mental health has attracted attention and services have undergone reform, resources are typically scarce, inequitably distributed, and inefficiently deployed. Social inclusion of those with psychosocial disabilities languishes as a distant ideal.
In practice, therefore, the international community still tends to prioritise human rights while largely ignoring mental health, which remains in the shadow of physical-health programs. Yet not only do persons with mental disorders suffer deprivations of human rights but violations of human rights are now recognized as a major cause of mental disorder - a pattern that indicates how inextricably linked are the two domains.
This volume offers the first attempt at a comprehensive survey of the key aspects of this interrelationship. It examines the crucial relationships and histories of mental health and human rights, and their interconnections with law, culture, ethnicity, class, economics, neuro-biology, and stigma. It investigates the responsibilities of states in securing the rights of those with mental disabilities, the predicaments of vulnerable groups, and the challenge of promoting and protecting mental health. In this wide-ranging analysis, many themes recur - for example, the enormous mental health burdens caused by war and social conflicts; the need to include mental-health interventions in humanitarian programs in a manner that does not undermine traditional healing and recovery processes of indigenous peoples; and the imperative to reduce gender-based violence and inequities. It particularly focuses on the first-person narratives of mental-health consumers, their families and carers, the collective voices that invite a major shift in vision and praxis.
The book will be valuable for mental-health and helping professionals, lawyers, philosophers, human-rights workers and their organisations, the UN and other international agencies, social scientists, representatives of government, teachers, religious professionals, researchers, and policy-makers. More information here
International Human Rights and Mental Disability Law: When the Silenced are Heard (American Psychology-Law Society Series) Michael L. Perlin (2011)
Society is largely blind-often willfully blind-to the ongoing violations of international human rights law when it comes to the treatment of persons with mental disabilities. Despite a robust set of international law principles, standards and doctrines, and the recent ratification of the United Nations' Convention on the Rights of Persons with Disabilities, people with mental disabilities continue to live in some of the harshest conditions that exist in any society. These conditions are the product of neglect, lack of legal protection against improper and abusive treatment, and social attitudes that demean, trivialize and ignore the humanity of persons with disabilities.
International Human Rights and Mental Disability Law: When the Silenced are Heard draws attention to these issues in order to shed light on deplorable conditions that governments continue to ignore, and to invigorate the debate on a social policy issue that remains a low priority for most of the world's nations. Examining the mistreatment of persons with mental disabilities around the world, Michael Perlin identifies universal factors that contaminate mental disability law, including lack of comprehensive legislation and of independent counsel; inadequate care; poor or nonexistent community programming; and inhumane forensic systems. Using examples from Western and Eastern Europe, South America, Africa and Asia, Perlin examines and summarizes the growing field of international mental health law, arguing that governmental inaction demeans human dignity, denies personal autonomy, and disregards the most authoritative and comprehensive prescription of human rights obligations. As Perlin argues, these issues pertain to all citizens of the world who value human rights and who care about how we treat those of us who may be most vulnerable. International Human Rights and Mental Disability Law is an indispensable resource for scholars, policymakers, governmental officials, and mental health professionals who care about the treatment of those with disabilities, and to human rights advocates and activists worldwide. More information here
Rethinking Rights-Based Mental Health Laws (2010) Bernadette McSherry (Editor), Penelope Weller (Editor)
Mental health laws exist in many countries to regulate the involuntary detention and treatment of individuals with serious mental illnesses. 'Rights-based legalism' is a term used to describe mental health laws that refer to the rights of individuals with mental illnesses somewhere in their provisions. The advent of the United Nations Convention on the Rights of Persons with Disabilities makes it timely to rethink the way in which the rights of individuals to autonomy and liberty are balanced against state interests in protecting individuals from harm to self or others. This collection addresses some of the current issues and problems arising from rights-based mental health laws. The chapters have been grouped in five parts as follows: - Historical Foundations - The International Human Rights Framework and the United Nations Convention on the Rights of Persons with Disabilities - Gaps Between Law and Practice - Review Processes and the Role of Tribunals - Access to Mental Health Services Many of the chapters in this collection emphasise the importance of moving away from the limitations of a negative rights approach to mental health laws towards more positive rights of social participation. While the law may not always be the best way through which to alleviate social and personal predicaments, legislation is paramount for the functioning of the mental health system. The aim of this collection is to encourage the enactment of legal provisions governing treatment, detention and care that are workable and conform to international human rights documents. More information here
Mental Health Policy: Global Policies and Human Rights Peter Morrall (Author), Mike Hazleton (Author) (2003) Wiley-Blackwell
Mental health has become a global issue. Throughout both the developed and developing worlds, the treatment and care of the mentally disordered, and the need to improve the mental health of all citizens, has become a major political and professional concern. This text sets out to monitor and analyse what supra–national and national policies have been and are being implemented, and to indicate what general themes and contradictions exist in the delivery of these policies. The implications from this review are then applied to professional practice – in particular that of the psychiatric disciplines (psychiatry and mental health nursing). A series of case studies from across the world is presented. Each is written by a pre–eminent scholar in the field of mental health policy within a selected country. The case studies have been chosen on the basis of their geographical location to ensure that there is a spread of exemplars from across the world and/or because of a unique approach to managing the mentally disordered. More information here
Journeys Towards Equality Taking Stock of New Zealand’s Efforts to Reduce Discrimination Against People with Experience of Mental Illness by Beven Yee and Hilary Lapsley (2004) Published by Mental Health Commission, New Zealand.Anti-discrimination work in mental health is more than policy change; it’s about local and national activities that change behaviour and attitudes on a day to day basis. This report provides a description and analyses of all major mental health anti-discrimination work in New Zealand up to 2004. Access from this website (Click on Title at top of list of publications)
Respect Costs Nothing A survey of discrimination faced by people with experience of mental illness in Aotearoa New Zealand by Debbie Paterson et al. (2004) Published by Mental Health Foundation of New Zealand. This report describes the findings of research undertaken to find out about people’s experiences of discrimination due to their experiences of mental illness. The research focused on the nature of the actual discrimination experience, highlighting that discrimination in New Zealand existed in all parts of people’s lives – employment, health services, communities, friends and family. Access from this website
Let the Sunshine In A Framework for Anti-Discrimination Work (2003) by Mary O'Hagan In this framework, Mary provides an understanding and user friendly framework for planning and evaluating anti-discrimination work, largely based on the work of Liz Sayce (England) and Hamish McKenzie (New Zealand). Download - Pdf
World Health Organisation Mental health, human rights and legislation. WHO provides support to countries in developing and implementing progressive mental health laws that promote and protect the rights of people with mental disorders. Visit site here
Human Rights Act 1998 A general guide to the Human Rights Act, with information about your human rights and what you can do if someone doesn’t respect them. Applies to England and Wales. Source: Mind, England Access from this website
Mental Health Declaration of Human Rights by Citizens Commission on Human Rights All human rights organisations set forth codes by which they align their purposes and activities. The Mental Health Declaration of Human Rights articulates the guiding principles of CCHR and the standards against which human rights violations by psychiatry are relentlessly investigated. Access from this website