Thoughts on the Global
and U.S. Movements

I’ve just returned from a meeting of 17 activists self-identified as users or survivors of psychiatry, or people with psychosocial disabilities, from all over the world.  Literally all over the world.  An international gathering of human rights defenders that makes me proud to be among them.  This was a strategic planning meeting of the World Network of Users and Survivors of Psychiatry, held from May 13-17 in Cape Town, South Africa.  You can read the materials preparatory to the conference and watch also for outcome documents which are being finalized.

It was a meeting where I felt heard and acknowledged and able to fully give what I had to give – to offer it up along with everyone else’s contributions for the common deliberation.  I gave all and received all in return.

Coming back, I am required to rethink again, who I am and what I do in this movement.  Not much will change, I think.  I am already on a path of doing human rights advocacy focused on abolition of forced psychiatry, and all the implications of that.  I am most interested and comfortable with standard-setting, elucidating what must be in order to end human rights violations.

To the extent that monitoring processes (i.e. advocacy with UN treaty monitoring committees, Special Rapporteurs etc.) are about standard-setting, further development of standards set out in a treaty, it is easy to see monitoring as part of my work.  I have been much less comfortable with implementation – creation of systems and practices that will bring change on the ground in the context of a given legal system and society.  Law reform seems unimaginable in the United States.  I have thought for many years – since around 1999 when it first occurred to me – that in New York what must be done is to repeal Article 9 of the Mental Hygiene Law – the encapsulated body of law that authorizes involuntary commitments.  But law reform to enact full recognition of legal capacity and a supported decision-making paradigm, doing away with guardianship, substituted decision-making and incapacity of any kind, is daunting.  One reason is that, while I have been comfortable as a survivor of psychiatry and member of this movement since 1978, in drawing out the human rights law implications of our advocacy for the abolition of forced psychiatry, I’m not comfortable speaking for other constituencies that have to be heard in relation to legal capacity:  older people, children, people with intellectual disabilities, people with brain injuries etc.  I want a collaborative process, an interactive process where we inter-see with each other what is needed to create a common vision.

In Cape Town I talked about the way my work has developed since the end of the CRPD process, which is embodied in the five activity areas identified and pursued by CHRUSP-Center for the Human Rights of Users and Survivors of Psychiatry.  These are:  securing good interpretation of the CRPD treaty provisions; law reform; monitoring and enforcement; human rights education/sharing of information; and extending the analysis in further standard-setting processes.  I have managed to work on all these areas so far except for law reform.  My work on education has largely been in the form of informal mentoring and guidance, as well as public information-sharing like this blog and the CHRUSP website.  I’ve been working on shadow reporting, or human rights monitoring – a good process has begun with other activists that connects the UN human rights standards with concerns coming out of issues in the U.S., that brings me closer to thinking about implementation, and to monitoring that is geared to using the tools rather than continuing to create and refine them.

Something that Cape Town taught me:  it is possible to follow our own instincts and intuitions, to be guided by inner wisdom, to trust ourselves and come out with something precious.  This could not have happened if we were dictated to in any way from outside.  We received funding for the meeting, and it could not have happened without the benefit of that funding and the structure that was generated.  But at the same time we needed to dance, and we did.  I am hopeful for the future of WNUSP – the older and younger leaders from every region, especially our hosts in Africa, who are prepared to take the movement forward.

I want to learn to navigate this dance in the U.S.

The conditions for creating change require that we engage with political actors, with the “powers that be.”  Most of us are effectively shut out of any political process – not only the legislative processes but also advocacy with agencies like SAMHSA, and even political discourse in the media.  I see the value of Occupy Psychiatry and the anti-APA demonstrations, and much of the public awareness-raising done by MindFreedom, by this website, and by many independent activists who are largely unsung and unrewarded.  Maybe it is all moving towards change, a pressure building until it bursts.  I hope that is so.

I want to engage with the opportunities for collaboration, to get to know more of the activist landscape, and to get to know the powers that be and explore whether there is anything we can do together.  And I will be testing any opportunity in terms of whether it allows us to dance with some structure or whether it is ruled by a structure and allows only passive assent.

I particularly want to look at the question of legal capacity in the U.S., to break it down into some manageable piece that I can work on.  What would it mean for people labeled with psychiatric diagnoses, what legal forms would we want to have in place if any to implement a change from substituted to supported decision-making?   What would be the desirable form of a law that recognized our full legal capacity at all times (beyond the issue of abolishing psychiatric commitment and forced treatment)?   A proposal of this nature would have to engage with current laws – not to fit into legal doctrines of capacity/incapacity but to search out where those doctrines are manifested in our law – and conceive of how the laws could be changed to an equality-based framework.  It would also have to engage with the work our community has done on advance directives, which can potentially help to transition to full legal capacity and can also be adapted to serve as guidance for conversations in a time of crisis, once full legal capacity is implemented.

A few other initiatives that people may want to support or become involved with:

• June 26 is the International Day in Solidarity with Victims of Torture.  A few of us have talked about using this day to promote the recommendations of the Special Rapporteur on Torture calling for an absolute ban on forced psychiatric interventions.  How can this be achieved?  What would the world look like?  
• Are there any activists out there who have survived the psychiatric system and the prison system, who are interested in working on UN advocacy on the rights of prisoners?  Please get in touch with me through info at chrusp dot org if interested.
• Maxima Kalitventsev and I, along with other activists, plan to return to Geneva for advocacy to the UN Human Rights Committee (see my earlier post “The UN Asks the US to Defend its Use of Forced Drugging“).  We are working on a full written report on abuses by the psychiatric industry that have the approval of the U.S. government, including forced medication.  We have set up a “Cause” to raise funding for the trip to Geneva.