Strengthening Civil and Political Rights of People with Mental Illness

The civil and political rights of people with mental illness1Drew N Funk M Tang S et al.Human rights violations of people with mental and psychosocial disabilities: an unresolved global crisis.Lancet. 2011; 378: 1664-1675Summary Full Text Full Text PDF PubMed Scopus (233) Google Scholar continue to be violated across the world. What little resources are allocated to addressing mental illness are strictly focused on medical treatment of patients, not their right to live with dignity as equal members of society. Herein lies the greatest paradox in psychiatry and global mental health. Global initiatives like the Movement for Global Mental Health and the Grand Challenges in Global Mental Health2Collins P Patel V Joestl S March D Grand challenges in global mental health.Nature. 2011; 475: 7-10Crossref PubMed Scopus (1406) Google Scholar advocate that effective psychiatric treatment exists3Patel V Araya R Chatterjee S et al.Treatment and prevention of mental disorders in low-income and middle-income countries.Lancet. 2007; 370: 991-1005Summary Full Text Full Text PDF PubMed Scopus (612) Google Scholar and what we need is to scale-up these services4Eaton J McCay L Semrau M et al.Scale up of services for mental health in low-income and middle-income countries.Lancet. 2011; 378: 1592-1603Summary Full Text Full Text PDF PubMed Scopus (421) Google Scholar to include the entire population who meet the criteria for treatment. However, in the absence of support from the beneficiary communities (ie, patients), real change in mental health—in which services are not only available but also sought—is unlikely. A cursory examination of the history of successful rights movements (for people with HIV, women, people with disabilities, and LGBT) shows the central role of the communities involved. In psychiatry, however, people with mental illness still have almost no stake. A prejudice, seemingly a result of the historical baggage of psychiatry, looms over mental health, including the global mental health movement, with professionals often continuing to view people with mental ill health simply as passive recipients of treatment. The Movement for Global Mental Health and the Grand Challenges in Global Mental Health do, however, hold tremendous potential to transform the scope and understanding of mental health globally. They would do well to learn from other rights movements. They must part ways with traditional psychiatry by vocally advocating the rights of people with mental ill health, ensuring that they are treated equally before the law and in society. Human rights are indispensable in mental health and must include the civil and political rights of those with mental ill health. The adoption of the United Nations' Convention on the Rights of Persons with Disabilities5UNConvention on the Rights of Persons with Disabilities and Optional Protocol. United Nations, New York2006Google Scholar in 2006 created an unprecedented opportunity to strengthen global advocacy for the social, political, and legal legitimacy of users of mental health services. If the global mental health movement fails to capitalise on this historic opportunity to make space for patients in their initiatives, mental health services will remain stigmatised and unwanted. I declare no competing interests. Human rights violations of people with mental and psychosocial disabilities: an unresolved global crisisThis 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. Full-Text PDF