2017: A Wake-up Call on Mental Health and Human Rights

Alva Finn
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We all have rights, we all have mental health: the two are undeniably intertwined, but until 2017 they had rarely been addressed together in the international arena. Earlier last year, the UN Special Rapporteur on the right to health, Dr Dainius Puras (himself a psychiatrist), released his groundbreaking report on the right of everyone to mental health. This was preceded by another excellent report on human rights and mental health by the UN Office of the High Commissioner for Human Rights. Most recently, the Human Rights Council adopted its second Resolution on mental health and human rights. There is something in the air, isn’t there? At Mental Health Europe (MHE), we see 2017 as having been a crossroads for mental health and human rights.

The report by the UN Special Rapporteur is the most comprehensive look at the state of play regarding the right to mental health following the adoption of the United Convention on the Rights of Persons with Disabilities in 2006. MHE believes in the transformative power of human rights as a tool not only for change within mental health services but for changing how we understand mental health. In response to the UN Special Rapporteur’s report, MHE along with its member the British Psychological Society, led an open letter which was signed by over 200+ organisations and individuals, including Mad in America, representing people across the spectrum of the mental health community (users and survivors, people with psychosocial disabilities and lived experience of mental distress, journalists and media outlets, professionals, academics and service providers) in Europe and abroad. Human rights can be a divisive issue among the mental health community, and our aim was to bring together organisations and individuals across the world who believed in the message of the Special Rapporteur — that things need to change.

What the report says

“The history of psychiatry and mental health care is marked by egregious rights violations”

“We have been sold a myth that the best solutions for addressing mental health challenges are medications and other biomedical interventions.”

“Conventional wisdom based on a reductionist biomedical interpretation of complex mental health-related issues dominates mental health policies and services, even when not supported by research.”

“For decades now, an evidence base informed by experiential and scientific research has been accumulating in support of psychosocial, recovery-oriented services and support and non-coercive alternatives to existing services.”

MIA readers will particularly appreciate the shift away from the World Health Organisation’s approach, which speaks to a ‘global burden of disease’, towards overcoming what the UN Special Rapporteur instead calls the Global Burden of Obstacles to achieving the right to mental health for all. These obstacles include the dominance of the biomedical model, power asymmetries and the biased use of evidence within the mental health field.

What the letter says

The letter welcomes and endorses the report which highlights that mental health has been a forgotten issue for far too long, leaving too many people to suffer human rights abuses within mental health services. The signatories also voiced their support for the Rapporteur’s calls for a shift away from isolating mental health services which are coercive and inappropriately medicalised to ones that are recovery and community-based and promote social inclusion. It endorses the positive messages for a global approach to health and psychological wellbeing and ensures the participation of a diversity of rights-holders and relevant stakeholders, including users and survivors of services, civil society and communities, and empowers them.

Action not just words

Of course, letters and reports don’t bring change on their own. MHE is dedicated to having the hard conversations that we need to have within the mental health community and beyond about how we can make change happen. There are promising practices across the world that help to support people with mental health problems in ways that respect their human rights. There are population level interventions which address the social determinants of mental health which would enable us to really start preventing mental ill-health but also improving mental well-being for everyone. However, we won’t advance human rights in mental health simply by having arguments between academics or clinicians or even service users, but by truly enacting this as a civil rights movement. Academics and experts have their role to play, but this isn’t just an academic or professional exercise; it’s about us as citizens and users and survivors of services. The MIA community has contributed vastly to bringing these issues to the fore as a civil rights problem, however we need to think about how we can make this a genuine civil rights movement that engages the world outside this community, including the general public, policymakers and the mainstream media.

Let’s ensure that this crossroads for mental health and human rights yields concrete change in 2018 and the coming years with the support of like-minded communities ready to take the discussion about mental health and human rights to the next level.

We want to reach out to the public, to the media, people with lived experience, survivors of psychiatry, communities, policymakers, psychiatry, all mental health professionals, families and carers to hear their views on human rights and mental health and get them engaged. If you are interested in signing up to the letter or engaging in this conversation, get in touch with us at: [email protected] (for the letter) or tweet @mhesme and one other organisation or influencer that you think needs to hear our message or could help get the message out, like a politician or a journalist, with the hashtag #mentalhealthrights. You can also find some of our tools on human rights (i.e., webinars, positions, toolkits and animated videos) on our website: http://www.mhe-sme.org/.

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Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.

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27 COMMENTS

  1. I’m hearing the alarm alright, but for another entirely different reason. Here in the USA we lost big time with this deal the Republicans cut with the Democrats to get what they were calling mental health reform. I’m talking about the Murphy bill that was incorporated into legislation designed to salvage part of the Obama administration’s affordable care act which passed. I’ve heard people talking about this legislation putting the movement back maybe 30 years. I wouldn’t imagine the rest of the world is necessarily headed in a better direction.

    I don’t see how I can support your efforts or your letter. The WHO was very right to speak of the “burden of disease”, only here it’s not really disease were talking about. One could say that, in this instance, much of the working world is suffering from the burden of disability fraud masquerading as disease.

    “Mental health” doesn’t = access to mental health treatment, nor does such access insure anything resembling “mental health”. It does make for much bureaucracy though because isn’t that what this is about, getting governments to foot the tab for so called mental health treatment?

    While you mention “non-coercive alternatives” and “human rights” at no point do you mention a person’s right to refuse or decline unwanted mental health treatment. All coercive mental health treatment is a human rights violation. If this is not made absolutely clear, we collude with our oppressors.

    I don’t see human rights in access to treatment. I do see human rights in the choice to refuse or decline such treatment. What do you get out of access to treatment? You get more and more so-called “mental illness”. What do you get out of the upholding people’s rights to make their own decisions in this matter? You get, potentially anyway, less and less “mental illness”. That’s a big difference.

    • Hi there, thanks for your comment. At Mental Health Europe we have taken a position, in line with the United Nations Convention on the Rights of Persons with Disabilities, against forced placement and treatment. We advocate for supported rather than the substitute decision-making regimes which currently feature in mental health laws the world over and for the reform of these systems. While this is a very important point, the UN Special Rapporteur’s report says much more than I could in a simple blog post about what the right to mental health means which indeed goes far beyond just the right to access treatment and issues around coercive treatment, and involves the social determinants of health, freedom from abuse and violence etc. Having read your comment, I think you would find much to agree with in the report and I hope that you will read it.

      • Perhaps true, but, I imagine, only to a degree, if so. I don’t think these organizations (the MHE is the European version of the MHA), as a rule, can come out with a clear statement opposing force because I think they are so compromised that that can never be their aim.

        It’s one thing to say:

        “We advocate for supported rather than the substitute decision-making regimes which currently feature in mental health laws the world over and for the reform of these systems.”

        It’s another to say:

        We demand the abolition of all non-consensual coercive mental health treatment.

        I think the UN Special Rapporteur’s report might speak to some of these things, but the problem here is working with these other organizations who are more keen on rights aimed at having the state protect the individual than on those rights aimed at protecting the individual from the state. The first set of rights have more to do with maintaining a dependence (disability payments and treatment compliance) while the second set have more to do with attaining independence (mental patients’ liberation). It is my feeling that some of us have lost sight of one goal almost completely by focusing on the other, and I think it is the lesser of the two goals that ends up being promoted.

        • Hi there, thanks for engaging. I just wanted to clarify something – MHE has no affiliation or connection to MHA. Our organisation is a European membership organisation representing associations and individuals in the field of mental health including users and survivors of mental health services, professionals, service providers and volunteers. We don’t provide services and we have never accepted any financial support from Pharma. We have however, always been underlined by a commitment to human rights. If you’d like to read our position on supported decision-making and forced placement and treatment, you can see that here: https://mhe-sme.org/what-we-do/human-rights/. We are also about to launch a report which maps the situation in Europe on institutionalisation and involuntary measures which we hope can shift systems away from the use of coercion.

          In terms of the division you have proposed between rights. I don’t see it as one obligation versus another. Human rights are indivisible, interdependent and interrelated. Without the first and second set of rights you mentioned, people will never truly enjoy their human rights fully. The issues you mention above are interlinked, many people with disabilities rely on disability benefits to maintain their independence, for example.

          Thank you for engaging with the blog! This is just the sort of discussion that is needed and I really do encourage you to read the report.

  4. How anyone speaking the truth, could support the half truths in this article, as if it was remotely a solution, is beyond me.
    We know that the NIMH withdrew all funding for the DSM5 owing to a total lack of scientific credibility, thus forcing the APA to pay to publish that manifesto of eugenics and genocide itself.
    We know that misdiagnosis and mistreatment of trauma,“medical mimics” and social problems being mislabel as “mental illness, chemical imbalances and brain disease’s” is medical malpractice and insurance fraud.
    We know that there is not a shred of science proving the existence of any “mental illness” and yet these medical frauds continue to twist and skew the the message in order to keep the fraud alive.
    We know that when “dr’s” who misdiagnosing people with cancer or other diseases they don’t have for profit, get caught, they go to prison as they should. And we know that is not happening to ‘mental illness’ pushers, but that it absolutely NEEDS to happen- NOW.
    We know that the DSM/ICD and any organization supporting the notion that “mental illness” is anything but a social construct and invention of the biological medical model, to justify coercion/force, mass misinformation, is selling drugs to make the 1% richer and is part of the systemic corruption that is harming the public.
    We know that Allopathic “medicine” is a monopoly that functions as a drug cartel that cornered the market share on selling its toxic wares by maligning and blocking insurance coverage of natural health and healing, thus leaving the public ignorant about and defendant on a wholly sub-standard toxic “sick-care” industry that gets away with mass-murder.
    Rhetorically, what does this even mean… “We all have mental health?” Only someone profiting from a ([email protected]%^%*)”mental illness” agenda could utter such a statement and position themselves on the right side of this medical tragedy.
    This year, lets challenge the hell out of the half truths supporting those earning a living off towing the line between truth and lies that are harming and killing the public.
    The dangers of willful blindness- Margaret Heffernanj
    https://www.ted.com/speakers/margaret_heffernan

    • A right to be a conforming automaton? A right to be a Stepford wife?

      Yeah, right…I like your attitude. As for “advocacy,” when the Congress decided to railroad the Murphy Bill through the voting process while everyone was distracted during the July 4 holiday, none of the professional “advocates” could be found as they were all on “vacation.”

      One thing —

      there is not a shred of science proving the existence of any “mental illness”

      It doesn’t even make it to the point of needing evidence, anyone familiar with the rules of language should understand that the mind is not an organ, it is an abstract concept and cannot have physical properties such as “disease.” A “mind” can be “ill” only in a metaphorical sense, like a “sick” joke. But you don’t find them developing pharmaceuticals for jokes, do you?

    • Hi there, thanks for your comments. I just wanted to say that at my organisation we endorse a psycho-social approach and we try to fight back against the ‘disease’ and illness model. That’s why we don’t use terms like mental illness, disease or disorder. We have raised many of the concerns that you have regarding scientific evidence and diagnosis in relation to DSM-V and are currently trying to raise the alarm on this within the framework of the current revision of the International Classification of Diseases.

  5. I don’t think we all have a “right to mental health.” What does that mean?

    I’d suggest we have a right to live free of abuse and oppression, and to have those responsible for such oppression held fully accountable for their actions. If those rights are enforced, “mental health” will improve for all of us with no “treatment” whatsoever.

    • Hi there, thanks for your comment. According to human rights law, we also have a right to be free from abuse and violence which is intimately linked to our right to health, both physical and mental. I’d recommend having a look at the UN Special Rapporteur’s report to see a more full, though not exhaustive, examination of what the ‘right to mental health’ means. You will see, for example, that freedom from violence, abuse etc can also be viewed as a precondition or a determinant of mental health. However, freedom from abuse and oppression are not the only determinants for mental health. There are many more and they effect everyone differently ie housing, access to water, supportive family environments etc. So I do think that we have a right to mental health which encompasses a range of different things including a right to access appropriate and quality health services, to non-violent environments that nurture rather than harm us etc

      • Thanks for the clarification. I hope you’ll consider whether a different term might be better, because the term “mental health” has been so critically co-opted by the industry that saying “a right to mental health” sounds immediately to me and others like “a right to mental health TREATMENT.”

        How about a right to “an environment that supports healthy physical, mental and emotional development?”

        Again, I appreciate the article and your work. Thanks for sharing it with us!

  7. I am an Antipsychiatrist because I believe that “mental illness” is a myth promoted by psychiatry; consistently, DSM definitions of “mental disorders” generally describe natural emotional suffering (or other natural problems with living). I accept the World Health Organization definition of “mental health” as “emotional well-being” but assume that emotions are natural while the WHO considers them diseases (without any biological support).

    I am dancing a fine line with definitions. “Mental health” generally connotes something physical; in contrast, I use the term as a social judgment about the relative desirability of different emotions (and behaviors). I believe that everyone has the right to “mental health” (positive emotions). I also believe that human rights promote “emotional health” (“mental health”) and that human rights violations predominately cause “poor ‘mental health’” (emotional suffering and other natural problems with living). Consistently, I agree with MHE about the right to “mental health” (“emotional well-being”) free of human rights abuses, and support your efforts.

    However, I do not understand how “mental health” can be promoted while simultaneously accepting the legitimacy of psychiatry- a “medical science” that assumes that emotional suffering (or other natural problem with living) is instead a disease.

    • “Mental health” generally connotes something physical…I also believe that human rights promote “emotional health” (“mental health”) and that human rights violations predominately cause “poor ‘mental health’” (emotional suffering and other natural problems with living). Consistently, I agree with MHE about the right to “mental health”

      These are not anti-psychiatry positions, as the framing of any emotional state, positive or negative, in terms of “health” mystifies the situation.

      • And what is the official way to demystify the situation when someone says that they think that Bill has a “mental health” problem? How about a “psychological” problem? I understand you to advocate that “mental disorders” address “nothing;” this response does not seem demystifying.

        • Maybe ask what they mean by that. Again, there are no correct answers because every situation is different, and people have learned to articulate themselves in certain ways, and sometimes mean different things by the same words. Maybe the correct question is “what about Bill do YOU have a problem with”? You still seem to be assuming that Bill “has” something that needs to be labeled, even if it isn’t a “mental disorder.”

      • I think it is as absurd to speak of a right to “mental health” as it is to speak of a right to “mental illness”, however, permit me to say that if madness were more tolerated (i.e. a right), we’d be better off.

        As you might note, any right to “mental illness” (or madness) would be in sharp contrast with any right to “treatment”, translated as a right to “mental health”, as much of that “treatment” is not requested.

        • Good point as well, though I was addressing the whole “health” metaphor as applied to feeling and behavior.

          I would concede that if these metaphorical terms hadn’t been so concretized and abused by psychiatry to justify what it does all this would seem like semantic nit-picking.

          • This is why I describe “mainstream ‘mental health’ care” as a classical paradigm in my video lecture; common terms have interrelated connotations and contexts that reinforce the false status quo.

  8. Dear Alva Finn,

    I’m still being blocked by my UK GP Surgery:

    EMAIL FROM ME TO:
    My Doctor Surgery, Newton Medical, Central London, UK.

    SUBJECT:- CHALLENGE TO DIAGNOSIS

    On Thu, 27 Apr 2017 at 11:20,

    Dear Partners/Manager,

    Please examine the email and attachments (below).

    I am keen to challenge the 1986 Irish Record Summary and any Mental Health Diagnosis you might hold on me.

    Please record the exact location of the attachments to this email trail on your information system, so that I can refer to them at a later date.

    (Resent Emails dated 29 August 2013 + 16 October 2014 – also contain more background information).

    N.B.
    I would ask for the Amendment of the 1986 Irish Record Summary (not Removal).

    Please acknowledge receipt of this email trail + attachments.

    Yours Sincerely

    ME

    (Forwarded Email From Me To Ombudsman)

    On Thu, 16 Feb 2017 at 10:58,

    Dear Kirsty,

    Would you please pass this Information email on to Joanne Dawson. I apologise for any unpleasantness attached to the contents.

    Please find attached:-

    1. The Relevant Sections of my November 8, 1986 Handwritten Adverse Drug Reaction Warning Request Letter (3 pages).

    2. The November 24, 1986 Irish Record Summary (2 pages) – With Requested Adverse Drug Reaction Warning Intentionally OMMITTED.

    3. My January 13, 2012 ‘Near Fatal Modecate Experience’ – ‘Statement’, sent to;- Galway University, Depot Side Effect Research & Monitoring Team

    4. Admitting Doctor, Dr Fadels description of me ‘on presentation’ at Galway in November 1980.

    5. The November 1986 False Reassurance Letter From Dr Donlon Kenny

    MALPRACTICE AT GALWAY 1986
    Please examine and reconcile the attachments to this email and please read through the background information to the offending drugs for perspective. My recovery after April 1984 was as a result of discontinuing these drugs.

    MALPRACTICE & DIAGNOSIS
    I don’t think a Medical environment engaging in Malpractice can be trusted to represent a Medical Opinion.

    BACKGROUND INFORMATION ON THE OFFENDING DRUG

    Suicide
    Associated with Akathisia and depot Fluphenazine (Modecate) treatment

    https://www.researchgate.net/publication/16313058_Suicide_Associated_with_Akathisia_and_Depot_Fluphenazine_Treatment 1983 (Dr K Shearer, Dr A Frances..)

    Dr A Frances went on to become Committee Chairperson to DSM 4.

    Akathisia
    I think I describe the symptoms of Akathisia fairly well in my November 1986 Handwritten ADR Request Letter + in My January 2012 ‘Statement’ to Galway University.

    https://en.m.wikipedia.org/wiki/Akathisia

    Wikipedia:- ‘Signs and Symptoms’
    “….Neuro-psychologist Dr. Dennis Staker had drug-induced akathisia for two days. His description of his experience was this: “It was the worst feeling I have ever had in my entire life…”….”

    Manufacturers Warning
    Adverse Drug Reaction
    https://dailymed.nlm.nih.gov/dailymed/archives/fdaDrugInfo.cfm?archiveid=7520

    “…The side effects most frequently reported with phenothiazine compounds are extrapyramidal symptoms including pseudoparkinsonism, dystonia, dyskinesia, akathisia….”

    Yours Sincerely

    ME

      • It looks like Dr Shipman Behavior is acceptable practise in “UK Mental Health”

        EMAIL Today from the UK Information Commissioners Office (Re. Above)

        On Wed, 10 Jan 2018 at 9:04, [email protected]
        wrote:

        10 January 2018

        Case Reference Number RFA0701553

        Dear Mr (ME)

        We write further to our telephone conversation on 4 January 2018 and in respect of the letter you sent to Newton Medical Centre on 12 December 2017.We also acknowledge receipt of your e-mail and attachments on 9 January 2018.

        In the letter to Newton Medical Centre you have asked them to:

        Inform you of the location of certain information about you on their computer system

        Explain why the information in attachments to your letter is a fair and accurate representation of your medical history

        Data Protection Act

        Under the Data Protection Act you do not have a right to ask about the location of information on Newton Medical Centre’s computer system or ask why they consider information in your medical file is fair and accurate.

        The fourth principle of the Data Protection Act (DPA) requires an organisation to take reasonable steps to ensure the accuracy of personal data they hold. This requirement relates to matters of fact, it does not relate to an opinion such as a medical diagnosis.

        A medical diagnosis is not a matter of fact as different doctors may hold different professional views. It is not possible for a medical diagnosis by a doctor to be challenged by anyone other than another doctor with a similar area of expertise.

        You cannot ask Newton Medical Centre to amend or remove a medical diagnosis from your records.

        You cannot ask Newton Medical Centre to amend or remove notes recorded by a doctor which led to their diagnosis. Doctors are required to keep contemporaneous notes of consultations and it would not be possible to challenge their recollection of events many years after a consultation or to prove that their recollection is incorrect.

        As explained in our letter of 5 December 2017 and in our telephone conversations you have the option to ask Newton Medical Practice to add a note to your file, stating that you disagree with information in your file or that you do not consider it to be complete.

        Please be aware that the Data Protection Act does not say anything about where a note should be added to an individual’s records. This means that you cannot ask for Newton Medical Practice to add a note at a certain point in your records or to add more than one note.

        The note should indicate that you disagree with the information in your records, but apart from this the Data Protection Act does not give any guidance about what information you can ask an organisation to add to your records. This means that Newton Medical Practice does not have to agree to add information to your records relating to your employment (such as character references and Construction Skills Certification Scheme ID cards).

        If Newton Medical Practice does not agree to add the note or information you want to your file the only option would be to make an application to the court under section 14 of the Data Protection Act.

        We cannot help you take court action, so if you want to consider this option we would recommend that you take legal advice.

        Next Steps

        We would recommend that you write to Newton Medical Practice and ask them to add a note to your records that you believe your medical records are inaccurate or incomplete. You can state what your opinion is, but the Practice are more likely to agree to your note being added if the statement is brief and does not require attached documents to be added.

        We would recommend that you ask for Newton Medical Practice to confirm in writing that they will add such a note to your file.

        Keep a copy of the letter you send to the Practice.

        If you do not receive a response after 28 days you may report the matter to us again.

        Yours sincerely

        (Name Removed)

        Case Officer
        Information Commissioner’s Office

  9. We need to organize and fight back against the entire mental health system. Alone, none of us can do that much. But organized, we could be an end to the entire mental health and recovery system, and being the abusers to justice, and reform many of the injustices upon which our society is based.

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