human rights and legislation who resource book on mental health

• confidentiality
• independent advocacy
• <strong>human</strong>e care <strong>and</strong> treatment
• transparent process.
Legislation should outline the procedure for submission, investigation <strong>and</strong> resolution of
complaints. An effective complaints procedure should be written in simple language <strong>and</strong> be
prominently displayed so that mental health care users or their families are informed of its
relevance, applicability, <strong>and</strong> how <strong>and</strong> where to lodge a complaint. The procedure should define
the time from the occurrence of the incident within which a complaint can be made, <strong>and</strong> specify
a maximum period within which the complaint must be responded to, by <strong>who</strong>m <strong>and</strong> how. In the
event of a user not being satisfied with the outcome of a grievance, the complaints procedure
should also specify the next or higher level to which the matter can be referred. An initial
complaint, ideally, should first be made to the health facility, <strong>and</strong> if unresolved, to the oversight
body.
It may be appropriate to appoint an ombudsperson with the authority to receive <strong>and</strong> investigate
complaints against mental health services. If appointed, that person should forward a report of
its investigations, along with recommendations, to the oversight body for appropriate action, <strong>and</strong>
penalties if necessary. The review body should set in place a procedure to prevent retribution
against patients filing complaints.
13.4 Procedural safeguards
Patients should have the right to choose <strong>and</strong> appoint a personal representative <strong>and</strong>/or a legal
counsel to represent them in any appeals or complaints procedure. Patients should also have
access to the services of an interpreter if necessary. The State should pay for the services of
such counsel <strong>and</strong>/or interpreter for patients <strong>who</strong> do not have the financial means to pay for such
services.
Patients (<strong>and</strong> their counsel) should have the right to access copies of their medical records <strong>and</strong>
any other relevant reports <strong>and</strong> documents during the complaints or appeals procedure. They
should also have the right to request <strong>and</strong> produce an independent mental health report <strong>and</strong> any
other relevant reports, as well as oral, written or other evidence during the complaints or appeals
procedure. In addition, patients <strong>and</strong> their counsel should have the right to request that a
particular person be present at a complaints or appeals procedure, if that presence is deemed
relevant <strong>and</strong> necessary.
Patients <strong>and</strong> their counsel should have the right to attend <strong>and</strong> participate in all complaints <strong>and</strong>
appeals hearings. The decisions arising out of the hearings should be expressed in writing <strong>and</strong>
copies given to patients <strong>and</strong> their counsel. When publicizing the decisions of the complaints or
appeals hearings, due consideration should be given to respecting the privacy of the patient <strong>and</strong>
other persons, <strong>and</strong> to the need for preventing serious harm to the patient’s health or putting the
safety of others at risk. Additionally, patients <strong>and</strong> their counsel should have the right to judicial
review of such decisions.
Review bodies: Key issues
An independent review body (or bodies) should be set up to protect the <strong>human</strong> <strong>rights</strong> of
persons with mental disorders. Countries may have separate bodies dealing with quasi-judicial
<strong>and</strong> other regulatory <strong>and</strong> oversight issues, or a combined structure.
• The functions of the quasi-judicial body with respect to involuntary admission/treatment or
other patients admitted or receiving treatment without consent should include assessing
each involuntary admission/treatment, entertaining appeals, reviewing the cases of patients
admitted on an involuntary basis at periodic intervals, regularly monitoring patients
receiving treatments against their will, <strong>and</strong> authorizing or prohibiting intrusive <strong>and</strong>
irreversible treatments.
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