The CRSPD The Convention on the Rights of Some Persons with Disabilities David Webb

1. The CRSPDThe Convention on the Rights of Some Persons with DisabilitiesDavid Webb

2. The Risk ofSelective Implementation of CRPD • governments only do the easy, cheap or popular bits • some people with disabilities are likely to be left behind • at greatest risk are people with psychosocial or intellectual disabilities, plus some other marginalised disabilities such as acquired brain injury etc • neglect or deliberate discrimination? Focus of this talk is people with psychosocial disabilities • i.e. people labelled as “mentally ill”

3. 2 Case Studies – local and global • Australia • human rights of people with psychosocial disabilities has gone backwards since Australia ratified CRPD • not surprising, given declarations made on ratification • e.g. current review of Victoria’s Mental Health Act • World Health Organisation (WHO) • Mental Health Division still living in a pre-CRPD world • leading role in medical colonisation of psychosocial disability in developing countries

4. VictoriaSubstituted Decision-making • Population – 5.5 million • Capital – Melbourne (pop. 4 million) • Guardianship and Administration Act (1986) • approx 1,300 people, mostly age-related dementia • Mental Health Act (1986) • 5,000+ on Involuntary Treatment Orders • “world champions” • e.g. equivalent to 50,000 in South Africa

5. Human Rights Context National: • no national Bill of Rights (or equivalent) • Disability Discrimination Act (1992) • Australia Human Rights Commission • Ratified CRPD July 2008 Victoria: • Charter of Human Rights (2006) • Disability Act (2006) – excludes psychiatric disability!

6. Article 17 – Australia’s declaration Australia recognizes that every person with disability has a right to respect for his or her physical and mental integrity on an equal basis with others. Australia further declares its understanding that the Convention allows for compulsory assistance or treatment of persons, including measures taken for the treatment of mental disability, where such treatment is necessary, as a last resort and subject to safeguards. • discriminates against people with “mental disability” • see also declaration on legal capacity (Art 12)

7. Mental Health Act Review May 2008: review commenced Dec 2008: Community Consultation Paper Jul 2009: Community Consultation Report Oct 2010: Draft Exposure Bill (400 pages) Mar 2011: Roundtable meetings Currently: Drafting of Bill Soon? Draft Bill submitted to Parliament • many human rights issues ... 2 outstanding violations ...

8. Human Rights Violation 1 Charter of Human Rights: • protects the right to refuse unwanted medical treatment • but allows for the limitation of a Charter right if it can be: “demonstrably justified in a free and democratic society” Despite this strict legal obligation ... • from outset, has assumed necessity of psychiatric force • but after 3 years, still no justification presented • effectively gagging debate on this critical issue

9. Human Rights Violation 2 Draft Exposure Bill: • introduces new test of “decision-making capacity” • controversial – e.g. discriminates against people with communications disabilities • but despite this, it still authorises medical treatment without consent even if a person: “has the capacity to consent to the administration of treatment for mental illness and does not give consent” If this was attempted for other disabilities (e.g. under Guardianship Act) there would be an uproar.

10. How Could This Happen? The human rights “industry” of Victoria includes ... • Victorian Equal Opportunities and Human Rights Commission (VEOHRC) • Office of the Public Advocate (OPA) • Human Rights Law Centre (HRLC) • Liberty Victoria • Law Institute of Victoria (LIV) All of whom made submissions which, like the government, endorse psychiatric force without offering any justification.

11. Summary • status quo assumptions and prejudices still dictate mental health legislation, policies and programs • CRPD and human rights legislation have not helped because they are simply ignored • human rights of people with psychosocial disabilities has gone backwards since Australia ratified CRPD Internationally, a similar story ...

12. WHOMental Health and Human Rights • WHO Resource Book on Mental Health, Human Rights and Legislation (2005) • Based on the “MI Principles” ... • UN Principles for the Protection of Persons with Mental Illness and the Improvement of Mental Health Care (1991) • which have been rejected by people with psychosocial disabilities and their DPOs since 1991

13. WHO Mental Health and Development • Mental health and development: targeting people with mental health conditions as a vulnerable group (2010) • “human rights-based approach ... coupled with the United Nations Convention on the Rights of Persons with Disabilities (CRPD)” • but silent on the single most important human rights issue in mental health ...

14. The Elephant in the RoomMedical treatment without consent • high risk medical interventions (ECT, neuroleptics) • based on controversial diagnostic system • foundation of most mental health laws • massive numbers of people • e.g. Victoria’s 5000+ on Involuntary Treatment Orders • e.g. widespread ECT without consent • being vigorously exported to developing countries • Western, medical colonisation of mental health • ... led by the WHO ...

15. Medical Colonialism • “Over the past thirty years, we Americans have • been industriously exporting our ideas about • mental health” • Anorexia in Japan • PTSD in Sri Lanka • Schizophrenia in Zanzibar • Depression in Japan • “Indigenous forms of mental illness and healing • are being bulldozed by disease categories and • treatments made in the USA.”

16. WHOContradictions – 2005 vs 2010 “The UN Principles for the Protection of Persons with Mental Illness and for the Improvement of Mental Health Care (1991) were developed without significant involvement by people with mental health conditions. As a result, the credibility of the Principles was diminished in the eyes of many, and resulted in a call to have them revoked. In contrast, the UN Convention on the Rights of Persons with Disabilities was drafted with the active participation of disability organizations, including mental health service user representatives. The Convention has been embraced widely by the disability movement as the universal standard for the human rights of all people with disabilities, and has taken precedence over previous instruments, including the UN Principles” (Mental health and development, 2010, p 15)

17. WHO stuck in a pre-CRPD world • still dominated by medical model of psychiatry • failure to grasp social model of disability and CRPD • has become silent on medical treatment without consent • silent on controversies on psychiatric diagnosis/treatment • promoting this model in developing countries • WHO must revise/rewrite its mental health human rights documents – urgently! • which must comply with the CRPD, including ... • active involvement of people with psychosocial disabilities and their DPOs

18. Conclusions – A Plea Please don’t forget us. Please don’t allow the implementation of the CRPD to transform it into the CRSPD – the Convention on the Rights of Some Persons with Disabilities. Nothing About Us Without US