Saturday, October 19, 2013

Psychiatric detention and drugging: Fear-mongering in the US, defending human rights at the UN

In a moment when a there’s a shameful and dishonest campaign underway in the US to stoke public fear of people diagnosed with a mental illness and push for their forcible incarceration and drugging, it’s encouraging to learn of positive international developments in protecting people’s human rights in psychiatric contexts.

Tina Minkowitz continues to report from the UN, where the Committee on the Rights of Persons with Disabilities has made it absolutely clear that “the ‘danger to self or others’ standard cannot legitimize psychiatric detention, and that all legislation authorizing such detention must be repealed.” As Minkowitz explains, Article 14 of the CRPD – which requires that “States Parties shall ensure…that the existence of a disability shall in no case justify a deprivation of liberty” – prohibits “commitment based on a psychiatric diagnosis plus criteria such as ‘danger to oneself or others’ [or ‘need for care and treatment’].”

Because this prohibition of psychiatric commitment was a dramatic departure from the previous standard, though, “there were many law professors, human rights organizations and, needless to say, governments, as well as the World Health Organization (which is highly influential in developing countries), that misinterpreted Article 14 to re-inscribe the old standard.”

This problem has persisted for some time, and last month Minkowitz went to Geneva to address the Committee. “My intention,” she describes,
was to encourage the Committee to makes its guidance entirely clear on the prohibition of psychiatric detention, and in particular on the prohibition of detention using a ‘danger to self or others’ standard, so that governments would be put on notice that they are committing human rights violations by continuing to apply their commitment laws.
Her efforts met with success, especially in that “the Concluding Observations adopted on the three countries under review – El Salvador, Austria and Australia – all take the resoundingly clear position that psychiatric detention is prohibited under Article 14.” Minkowitz quotes from the Concluding Observations on these three countries – Australia, for example, must repeal “legal provisions that authorize commitment of individuals to detention in mental health services, or the impositi[o]n of compulsory treatment either in institutions or in the community via Community Treatment Orders (CTOs).”

Furthermore, “The issues raised under Article 14 in the criminal context, in particular the prohibition of criminal or forensic psychiatric commitment, are now beginning to be addressed by the Committee and also by the Special Rapporteur on Torture.” Also, “with regard to the Committee’s stance against forced psychiatric drugging and other coercive practices, they are continuing to be quite firm, addressing forced psychiatry as a form of torture and ill-treatment as well as a violation of the right to free and informed consent in health care, the right to integrity of the person, and the right to legal capacity.”

Good policy can be made when decisions are based not on fear and propaganda but on respect for human rights (and just human beings). What’s more, as I think Ted Chabasinski has argued, defending human rights is inseparable from developing positive approaches to psychological problems. Denying governments the option of violent and coercive (and often commercially profitable) measures pushes people to consider, imagine, and create humanistic alternatives.

*This was an appallingly credulous and dangerous segment from 60 Minutes, blithely repeating long-debunked claims and simply refusing to seek out or even recognize other perspectives. To drive the problem home, watching it online I was treated to two ads for the “antidepressant” Pristiq.

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