human rights and legislation who resource book on mental health

5.3.4 Labour
Legislation can ban the use of forced labour in mental health facilities. This includes situations
where patients are forced to work against their wishes (for example, due to staff shortages within
the facility), or are not appropriately <strong>and</strong> adequately remunerated for work performed, <strong>and</strong> where
patients are made to perform the personal work of the institution’s staff in return for minor
privileges.
Forced labour should not be confused with occupational therapy. Nor should it be likened to
situations where, as part of a rehabilitation programme, patients must make their own beds or
cook food for people in their facility. However, there are certain grey areas, <strong>and</strong> any <strong>legislation</strong>
should strive to provide as much clarity on these issues as possible.
5.4 Notice of <strong>rights</strong>
Although <strong>legislation</strong> may provide many <strong>rights</strong> to persons with mental disorders, they are
frequently unaware of their <strong>rights</strong> <strong>and</strong> thus unable to exercise them. It is therefore essential that
<strong>legislation</strong> include a provision for informing patients of their <strong>rights</strong> when interacting with mental
health services.
MI Principles: Notice of Rights
1. A patient in a mental health facility shall be informed as soon as possible after admission, in a
form <strong>and</strong> language which the patient underst<strong>and</strong>s, of all his or her <strong>rights</strong> in accordance with these
Principles <strong>and</strong> under domestic law, which information shall include an explanation of those <strong>rights</strong>
<strong>and</strong> how to exercise them.
2. If <strong>and</strong> for so long as a patient is unable to underst<strong>and</strong> such information, the <strong>rights</strong> of the
patient shall be communicated to the personal representative, if any <strong>and</strong> if appropriate, <strong>and</strong> to
the person or persons best able to represent the patient’s interests <strong>and</strong> willing to do so.
(Principle 12(1) <strong>and</strong> (2), MI Principles)
Legislation can ensure that patients are given information about their <strong>rights</strong> on admission to a
mental health facility, or as soon after the admission as the patient’s condition permits. This
information should include an explanation of what these <strong>rights</strong> mean <strong>and</strong> how they may be
exercised, <strong>and</strong> be conveyed in such a way that patients are able to underst<strong>and</strong> it. In countries
where various languages are spoken, the <strong>rights</strong> should be communicated in the person’s
language of choice.
An example of a <strong>rights</strong> document – Your Rights as a Client or Patient, of the Connecticut
Department of Mental Health & Addiction Services – is presented in Annex 6. Annex 7 is a
summary of a patients’ <strong>rights</strong> document given to all mental health patients in Maine, USA.
It must be emphasized, however, that the levels of literacy <strong>and</strong> underst<strong>and</strong>ing of technical terms
<strong>and</strong> procedures are critical, <strong>and</strong> the examples provided may be inappropriate in many countries.
Nonetheless, countries can develop pamphlets, posters <strong>and</strong> tapes, for example, or use other
mechanisms that are easily understood <strong>and</strong> reflect the <strong>rights</strong> of people in their own country.
Legislation may make provisions for communicating these <strong>rights</strong> to personal representatives
<strong>and</strong>/or family members in the case of patients <strong>who</strong> lack the capacity to underst<strong>and</strong> such
information.
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