human rights and legislation who resource book on mental health

Example: The National Commission takes active steps to protect the <strong>rights</strong> of people with
mental disorders in Chile
As part of the overall health sector reform in Chile, a new charter on the <strong>rights</strong> of patients has
been introduced which has served to facilitate the implementation of measures to protect <strong>and</strong>
promote the <strong>rights</strong> of people with mental disorders. A National Commission for the Protection
of People with Mental Illness, with the participation of users <strong>and</strong> families, started work in
March 2001. A process of education of mental health workers about the <strong>rights</strong> of people with
mental disorders <strong>who</strong> are admitted to psychiatric facilities has been started in the country with
positive results. The common practice of psychosurgery for mental disorder associated with
violent behaviour has effectively been stopped in the country, violations of <strong>human</strong> <strong>rights</strong> in
some psychiatric facilities are being investigated, <strong>and</strong> people with mental disorder <strong>and</strong> their
families have been able to present their difficulties regarding access to treatment <strong>and</strong>
rehabilitation. As an example of the work of the Commission, prior to its establishment, every
year psychosurgery was performed, on average, on 40 patients for severe mental disorder
associated with aggressive behaviour. In the first two-<strong>and</strong>-a-half years after its establishment,
the Commission was requested to assess only 11 c<strong>and</strong>idates for psychosurgery <strong>and</strong> all were
turned down, as other more appropriate interventions, with less risk to the patient, were
available.
(Personal communication, Dr A. Minoletti, Ministry of Health, Chile, 2002)
5.2 Dissemination <strong>and</strong> training
The general public as well as professionals, people with mental disorders, families of people with
mental disorders, <strong>and</strong> advocacy organizations working on their behalf are frequently ill informed
about the changes brought about by new <strong>legislation</strong>. In some instances, they may be well
informed of the changes, but remain unconvinced about the reasons for these changes <strong>and</strong>
hence do not act in accordance with the law. This is especially true when mental health
<strong>legislation</strong> requires significant changes to their customary practices related to mental health.
5.2.1 Public education <strong>and</strong> awareness
Cultural <strong>and</strong> social values, beliefs, attitudes <strong>and</strong> traditions of a particular society influence
attitudes about mental health, mental disorders <strong>and</strong> people <strong>who</strong> experience them. Stigma,
myths <strong>and</strong> misconceptions associated with mental disorders lead to discrimination <strong>and</strong>
limitations on <strong>human</strong> <strong>rights</strong>, <strong>and</strong> can represent obstacles to effective implementation of <strong>human</strong><strong>rights</strong>-oriented
<strong>legislation</strong>. Hence, changing public attitude constitutes an important component
in implementing mental health <strong>legislation</strong>.
Disseminating information about mental health, including information about the <strong>rights</strong> provided
in new <strong>legislation</strong>, can help to change public attitudes towards people with mental disorders.
Public awareness programmes need to highlight special provisions in <strong>legislation</strong> <strong>and</strong> provide
explanations for their inclusion, such as why sections regarding access to mental health care
<strong>and</strong> for protecting the <strong>human</strong> <strong>rights</strong> of persons with mental disorders have been included. The
media can play a useful role in this process. They can highlight the importance of respecting
<strong>human</strong> <strong>rights</strong> of persons with mental disorders <strong>and</strong> assist in educating the public about
advances in the treatment of mental disorders, especially the effectiveness of community-based
rehabilitation programmes.
5.2.2 Users, families <strong>and</strong> advocacy organizations
It is necessary to educate, inform <strong>and</strong> train users of mental health services, their family members
<strong>and</strong> advocacy organizations. It is critical for these individuals <strong>and</strong>/or groups to know what the
<strong>legislation</strong> says, <strong>and</strong>, specifically, to know their <strong>rights</strong> as provided for in the <strong>legislation</strong>. The
importance of involving NGOs of users <strong>and</strong> their families in activities through the <strong>who</strong>le process
of drafting, consultation <strong>and</strong> adoption of mental health <strong>legislation</strong> has been emphasized in this
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