human rights and legislation who resource book on mental health

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5. Rights of users of mental health services 31 5.1 Confidentiality 32 5.2 Access to information 32 5.3 Rights <strong>and</strong> conditions in mental health facilities 33 5.3.1 Environment 34 5.3.2 Privacy 35 5.3.3 Communication 35 5.3.4 Labour 36 5.4 Notice of <strong>rights</strong> 36 6. Rights of families <strong>and</strong> carers of persons with mental disorders 38 7. Competence, capacity <strong>and</strong> guardianship 39 7.1 Definitions 39 7.2 Assessment of incapacity 40 7.2.1 Capacity to make a treatment decision 40 7.2.2 Capacity to select a substitute decision-maker 40 7.2.3 Capacity to make a financial decision 40 7.3 Determining incapacity <strong>and</strong> incompetence 41 7.4 Guardianship 41 8. Voluntary <strong>and</strong> involuntary mental health care 43 8.1 Voluntary admission <strong>and</strong> voluntary treatment 43 8.2 “Non-protesting” patients 45 8.3 Involuntary admission <strong>and</strong> involuntary treatment 46 8.3.1 Combined versus a separate approach to involuntary admission <strong>and</strong> involuntary treatment 47 8.3.2 Criteria for involuntary admission 49 8.3.3 Procedure for involuntary admission 50 8.3.4 Criteria for involuntary treatment (where procedures for admission <strong>and</strong> treatment are separate) 53 8.3.5 Procedure for involuntary treatment of admitted persons 53 8.3.6 Proxy consent for treatment 56 8.3.7 Involuntary treatment in community settings 57 8.4 Emergency situations 60 8.4.1 Procedure for involuntary admission <strong>and</strong> treatment in emergency situations 60 9. Staff requirements for determining mental disorder 61 9.1 Level of skills 61 9.2 Professional groups 62 10. Special treatments 62 10.1 Major medical <strong>and</strong> surgical procedures 63 10.2 Psychosurgery <strong>and</strong> other irreversible treatments 63 10.3 Electroconvulsive therapy (ECT) 64 11. Seclusion <strong>and</strong> restraint 64 12. Clinical <strong>and</strong> experimental research 66 13. Oversight <strong>and</strong> review mechanisms 67 13.1 Judicial or quasi-judicial oversight of involuntary admission/treatment <strong>and</strong> other restrictions of <strong>rights</strong> 68 13.1.1 Composition 69 13.2 Regulation <strong>and</strong> oversight body 69 13.2.1 Composition 70 13.2.2 Additional powers 70 13.3 Complaints <strong>and</strong> remedies 70 13.4 Procedural safeguards 71 14. Police responsibilities with respect to persons with mental disorders 72 14.1 Powers of the police 72 14.2 Responding to calls for assistance 73 xii
14.3 Protections for persons with mental disorders 73 14.3.1 Place of safety 73 14.3.2 Treatment options 73 14.3.3 Detention period 74 14.3.4 Prompt notification 74 14.3.5 Review of records 74 15. Legislative provisions relating to mentally ill offenders 75 15.1 The pre-trial stages in the criminal justice system 76 15.1.1 The decision to prosecute 76 15.2 The trial stage in the criminal justice system 76 15.2.1 Fitness to st<strong>and</strong> trial 76 15.2.2 Defence of criminal responsibility (mental disorder at time of offence) 77 15.3 The post-trial (sentencing) stage in the criminal justice system 78 15.3.1 Probation orders <strong>and</strong> community treatment orders 78 15.3.2 Hospital orders 78 15.4 The post-sentencing (serving sentence in prison) stage 79 15.5 Facilities for mentally ill offenders 79 16. Additional substantive provisions affecting mental health 81 16.1 Anti-discrimination <strong>legislation</strong> 81 16.2 General health care 81 16.3 Housing 81 16.4 Employment 82 16.5 Social security 82 16.6 Civil issues 82 17. Protections for vulnerable groups – minors, women, minorities <strong>and</strong> refugees 83 17.1 Minors 83 17.2 Women 84 17.3 Minorities 85 17.4 Refugees 85 18. Offences <strong>and</strong> penalties 86 Chapter 3 Process: drafting, adopting <strong>and</strong> implementing mental health <strong>legislation</strong> 89 1. Introduction 89 2. Preliminary activities 91 2.1 Identifying mental disorders <strong>and</strong> barriers to mental health care 91 2.2 Mapping of mental-health-related <strong>legislation</strong> 92 2.3 Studying international conventions <strong>and</strong> st<strong>and</strong>ards 93 2.4 Reviewing mental health <strong>legislation</strong> in other countries 93 2.5 Building a consensus <strong>and</strong> negotiating for change 95 2.6 Educating the public on issues concerning mental health <strong>and</strong> <strong>human</strong> <strong>rights</strong> 95 3. Drafting mental health <strong>legislation</strong> 96 3.1 The drafting process 96 3.2 The need for consultation 97 3.3 Inviting consultation 97 3.4 Process <strong>and</strong> procedure for consultation 99 3.5 Language of <strong>legislation</strong> 102 4. Adoption of <strong>legislation</strong> 103 4.1 Legislative process 103 4.1.1 Responsibility for adopting <strong>legislation</strong> 103 4.1.2 Debate of draft <strong>legislation</strong> <strong>and</strong> its adoption 104 xiii
Page 1: WHO RESOURCE BOOK ON MENTAL HEALTH,
Page 4 and 5: All rights reserve
Page 6 and 7: Technical contribution and<
Page 8 and 9: Nacanieli Goneyali Maria Grazia Gia
Page 10 and 11: Leen Meulenbergs Harry I. Minas Alb
Page 12 and 13: Harvey Whiteford Ray G. Xerri XIE B
Page 16 and 17: 4.1.3 Sanction, promulgation <stron
Page 18 and 19: For whom is this R
Page 20 and 21: This chapter covers five main areas
Page 22 and 23: 3.2 Violations of human</st
Page 24 and 25: 3.5 Promoting access to mental heal
Page 26 and 27: health legislation
Page 28 and 29: The right to health, as embodied in
Page 30 and 31: trade, torture and
Page 32 and 33: The MI Principles have also served
Page 34 and 35: 8.4 The Salamanca Statement <strong
Page 37 and 38: Chapter 2 Content of mental health
Page 39 and 40: persons with mental disorders. The
Page 41 and 42: Mental disability is not synonymous
Page 43 and 44: Mental Disability Mental Incapacity
Page 45 and 46: Definition of “mental ill health
Page 47 and 48: Example: Mental health in primary c
Page 49 and 50: Another means of promoting communit
Page 51 and 52: MI Principles: Access to informatio
Page 53 and 54: Legislation (or accompanying regula
Page 55 and 56: Rights of users of mental health se
Page 57 and 58: mentally ill offender. Countries ma
Page 59 and 60: 7.3 Determining incapacity
Page 61 and 62: • The presence of a major mental
Page 63 and 64: The concept of “voluntary” prec
Page 65 and 66:
The key issue for mental health <st
Page 67 and 68:
“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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Emergency situations: Key issues
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10.1 Major medical and</str
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MI Principles: Seclusion an
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The MI Principles and</stro
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Authorize or prohibit intrusive <st
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• confidentiality • independent
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14.2 Responding to calls for assist
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15. Legislative provisions relating
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For minor offences, the court could
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15.4 The post-sentencing (serving s
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16. Additional substantive provisio
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• Right to work and</stro
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In countries where women are detain
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Kenya The Mental Health Act (Act No
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Figure 2. Process of mental health
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) Qualitative information from focu
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When examining another country’s
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• The process of building a conse
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Consultation should be undertaken w
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Written submissions have the advant
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The group, body or individual(s) m<
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4.1.2 Debate of draft legis
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mental health facts and</st
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Example: The National Commission ta
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5.2.4 Developing information <stron
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Human resource iss
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Rosenthal E, Sundram C (2002). Inte
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Declaration of Hawaii (1983). Appro
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Bibliography Araya R et al. (2001).
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Introduction and h
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2) Does the legislation</st
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C. Access to mental health care 1)
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3) Does the legislation</st
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E. Rights of families or other care
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G. Voluntary admission and<
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) there is serious likelihood of ha
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• Patient lacks the capacity to m
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2) Are all the criteria and
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O. Special treatments 1) Does the l
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3) Does the law specify a restricte
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R. Oversight and r
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3) (iv) Maintain registers of accre
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• the right of patients a
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3) Does the law allow for people <s
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2) Does the law provide for “reas
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3) Does the law ensure that all min
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AZ. Offences and p
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• Inter-American Convention on th
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Civil and Politica
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5. A patient shall never be invited
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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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