Mad in Ireland editors Martha Griffin and Jennifer Hough spoke at the recent Centre for Criminal Justice and Human Rights mental health conference at University College Cork.
Their joint presentation was titled: Beyond the Current Paradigm: What Human Rights Really Means in Mental Health Law and was in response to the rowing back of human rights protections contained with the current mental health bill.
Ms Griffin said: “I am employed from the knowledge borne of pain and challenges. I thought we would be much further developed in terms of human rights and mental health than where we are currently. The proposed mental health bill is not in line with UNCRPD and is moving further away as the amendments are made.”
Quoting UN Special Rapporteur Dainius Pūras, Ms Griffin said “Mental health policies and services are in crisis – not a crisis of chemical imbalances, but of power imbalances…We need little short of a revolution in mental health care to end decades of neglect, abuse and violence.”
Ms Griffin also pointed to new ways of thinking and working with people people who have been diagnosed with psychosocial disabilities, for example the British Psychological Society (BPS) has developed the Power Threat Meaning Framework (PTMF) as an alternative way to view and respond the mental health challenges, and the WHO roadmap for community services that use non coercive practices.
Ms Hough told the conference that three years ago, during pre-legislative scrutiny for reform of the mental health act, there was genuine hope that it would finally put human rights at the core of mental health law.
“At that time, there were clear calls from the committee to put human rights at the very centre of the reformed Act and to move decisively away from a narrow biomedical view of mental health. But the bill before us now falls far short of this and continues to prioritise coercive practices over autonomy and consent.”
She continued: “In our mental health system, people live under the constant threat that if they disagree, if they refuse medication or admission, their wishes can be overridden and their freedom can be taken away. Even if coercion is not used, this hangs over everything as a control mechanism. That is not a system that protects dignity. It is a system that dehumanises. And it is out of line with the very core of human rights law.”
The overarching message from the joint presentation was that there are are different ways of understanding mental health problems and the biomedical approach does not adequately reflect the complex social, emotional, and developmental factors involved in mental health
It was argued that the way forward has to be a shared, rights-based approach grounded in law. This means taking sole legal responsibility away from the dominant profession of psychiatry.
“This is not to say psychiatry should not be part of a suite of measures available to people, but mental health care should be based around consent and choice — a right to person-centred services and choice should be enshrined in legislation, and requisite funding must be put into things like peer support, peer-run grassroots organisations and community interventions such as non-medical crisis houses and open dialogue,” Ms Hough added.