human rights and legislation who resource book on mental health

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Human <strong>resource</strong> issues are of particular importance for the implementation of <strong>legislation</strong> in all countries. Mental health professionals are key to the delivery of effective mental health care within specialized mental health services, both in general health care <strong>and</strong> in the community. Without sufficient numbers of professionals or adequate training, the primary objective of a mental health law, to improve mental health care, will fail. In addition, investment needs to be made in training all people <strong>who</strong> have a role to play in the implementation of the law (for example the judiciary, the police force, people serving on a mental health review body) in order to ensure that they are familiar with all aspects of the <strong>legislation</strong>, <strong>and</strong> with their own roles <strong>and</strong> responsibilities in putting its provisions into practice. Implementing mental health <strong>legislation</strong>: Key issues • Significant preparation is required to ensure the smooth introduction of new mental health <strong>legislation</strong>. The period between the passing <strong>and</strong> the enactment of <strong>legislation</strong> can be a particularly important time for organizing implementation procedures such as establishing review boards, training people on the new <strong>legislation</strong> <strong>and</strong> preparing those <strong>who</strong> will implement it. • Having st<strong>and</strong>ardized forms <strong>and</strong> other administrative processes in place facilitates the transition. • Procedures must be set up to monitor the implementation of <strong>legislation</strong>. This may be done by an independent body <strong>and</strong>/or by the implementing agency itself (e.g. the government). • Both the implementing <strong>and</strong> monitoring bodies should have timetables with measurable targets, <strong>and</strong> the powers to carry out their functions. • Changing public attitudes <strong>and</strong> reducing stigma <strong>and</strong> discrimination is an important component in ensuring the success of the <strong>legislation</strong>. • Users, families <strong>and</strong> advocacy groups need to have complete knowledge of the <strong>legislation</strong> in order to maximize the benefits. Training these groups is an essential aspect of implementation. • Mental health <strong>and</strong> other professionals also need to be trained to carry out the letter <strong>and</strong> the intention of the <strong>legislation</strong>. • Financial <strong>and</strong> <strong>human</strong> <strong>resource</strong>s to implement the <strong>legislation</strong> must be provided by the relevant authorities to give substance <strong>and</strong> credibility to the <strong>legislation</strong>. Negotiation for the provision of these <strong>resource</strong>s should be conducted simultaneously with the processes of drafting <strong>and</strong> adopting the <strong>legislation</strong>. As we have seen, progressive <strong>legislation</strong> on mental health can represent an important means of protecting the <strong>rights</strong> of people with mental disorders. In this Resource Book we have highlighted key international <strong>and</strong> regional <strong>human</strong> <strong>rights</strong> st<strong>and</strong>ards that governments have the obligation to respect, protect <strong>and</strong> fulfil. The Book also identifies what issues <strong>and</strong> provisions need to be included in a progressive mental health law. Finally, it also examines best practice strategies for the effective drafting, adoption <strong>and</strong> implementation of mental health law, highlighting difficulties <strong>and</strong> barriers <strong>and</strong> ways in which these can be overcome. It is every country's responsibility to act on this information <strong>and</strong> to generate the necessary political commitment for successful initiation/development or reform of mental health law <strong>and</strong> its implementation. 112
References American Psychiatric Association (1994). Diagnostic <strong>and</strong> Statistical Resource Book on Mental Disorders: DSM – IV, 4th ed. Washington, DC. Arboleda-Flórez J (2001). Stigmatization <strong>and</strong> <strong>human</strong> <strong>rights</strong> violations. World Health Organization, Mental Health: A Call for Action by World Health Ministers. Geneva, WHO: 57-70. Arjonilla S, Parada IM, Pelcastre B (2000). When mental health becomes a priority. Salud Mental [Mental Health], 23(5): 35-40. (In Spanish) BBC News (1998). Shackled day <strong>and</strong> night in Nigeria. BBC News web site at: (http://news.bbc.co.uk/1/hi/world/africa/76130.stm), accessed on 10 April. Beermann E. (2000). Patients’ <strong>rights</strong> protections, mental health <strong>legislation</strong> <strong>and</strong> patients’ advocacy services in Austria: Recognition <strong>and</strong> protection of patients’ <strong>rights</strong>. Paper presented at the International workshop in Budapest, 19-21 May 2000. Organized by the Hungarian Civil Liberties Union, supported by The Ford Foundation: 66-73. Bertolote JM, Sartorius N (1996). WHO initiative of support to people disabled by mental illness: Some issues <strong>and</strong> concepts related to rehabilitation. European Psychiatry, 11(Suppl. 2), 56s-59s. Congo v. Ecuador, Report 63/99, Case 11.427, April 13, 1999, Inter-American Commission of Human Rights, Organization of American States. Council for International Organizations of Medical Sciences (CIOMS) (2002). International Ethical Guidelines for Biomedical Research Involving Human Subjects. Prepared in collaboration with the World Health Organization. Geneva, WHO. Gostin LO (2000). Human <strong>rights</strong> of persons with mental disabilities. The European Convention of Human Rights. International Journal of Law <strong>and</strong> Psychiatry, 23(2):125-159. Harrison K (1995). Patients in the community. New Law Journal, 276:145. Henderson C et al. (2004). Effect of joint crisis plans on use of compulsory treatment in psychiatry: Single blind r<strong>and</strong>omised controlled trial. British Medical Journal, 329:136. International Digest of Health Legislation (2000). (http://www.<strong>who</strong>.int/idhl). Geneva, World Health Organization. Livesley J (2001). The H<strong>and</strong><strong>book</strong> of Personality Disorder. New York, NY, Guilford Press. Mental Disability Advocacy Center (MDAC) (2003). Caged Beds: In<strong>human</strong> <strong>and</strong> Degrading Treatment in Four EU Accession Countries, Budapest, Mental Disability Advocacy Center. Mental Disability Rights International (2000). Report on Human Rights <strong>and</strong> Mental Health: Mexico. Washington DC, Mental Disability Rights International. Rosenthal E, Éva Szeli E (2002). Not on the Agenda: Human Rights of People with Mental Disabilities in Kosovo. Washington DC, Mental Disability Rights International. 113
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WHO RESOURCE BOOK ON MENTAL HEALTH,
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All rights reserve
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Technical contribution and<
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Nacanieli Goneyali Maria Grazia Gia
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Leen Meulenbergs Harry I. Minas Alb
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Harvey Whiteford Ray G. Xerri XIE B
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5. Rights of users of mental health
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4.1.3 Sanction, promulgation <stron
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For whom is this R
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This chapter covers five main areas
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3.2 Violations of human</st
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3.5 Promoting access to mental heal
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health legislation
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The right to health, as embodied in
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trade, torture and
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The MI Principles have also served
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8.4 The Salamanca Statement <strong
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Chapter 2 Content of mental health
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persons with mental disorders. The
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Mental disability is not synonymous
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Mental Disability Mental Incapacity
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Definition of “mental ill health
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Example: Mental health in primary c
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Another means of promoting communit
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MI Principles: Access to informatio
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Legislation (or accompanying regula
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Rights of users of mental health se
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mentally ill offender. Countries ma
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7.3 Determining incapacity
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• The presence of a major mental
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The concept of “voluntary” prec
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The key issue for mental health <st
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“separate” process from admissi
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In some cases, certain families bel
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as an inpatient or outpatient. This
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Example: Successful appeal of an ad
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8.3.7 Involuntary treatment in comm
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Figure 1. Procedure for combined in
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Page 103 and 104: In countries where women are detain
Page 105: Kenya The Mental Health Act (Act No
Page 108 and 109: Figure 2. Process of mental health
Page 110 and 111: ) Qualitative information from focu
Page 112 and 113: When examining another country’s
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Page 132 and 133: Rosenthal E, Sundram C (2002). Inte
Page 134 and 135: Declaration of Hawaii (1983). Appro
Page 136 and 137: Bibliography Araya R et al. (2001).
Page 138 and 139: Introduction and h
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Principle 15 Admission principles 1
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Principle 20 Criminal offenders 1.
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Annex 5. Extract from the Declarati
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5. Organ Transplantation: The role
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Restraint & Seclusion: If condition
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Rights of Recipients Summary in Eng
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PART C TAKING PERSON TO APPROVED ME
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I base my opinion on the following
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Annex 9. Example: New Zeala
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Who can make an advance directive?
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