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Box 14 Box 15 access to legal procedures that promote and protect their rights. For example, they can encourage the establishment of mechanisms within the justice system to prevent abuses in relation to involuntary admission and treatment in mental health facilities. They also can promote access to complaints mechanisms for people with mental health conditions. 49 Mental health law as a catalyst for reform in South Africa 222 SouthAfrica’sMentalHealthCareAct, 223 passedin2002,illustrateshow thelanguageandcontentofthelawcanbechangedtoreflectinternational humanrightsandbestpracticestandards.Thelawwasdevelopedthrough wideconsultation,promotesanintegratedapproachtomentalhealth,and hasdrivenservicereformatprovincialanddistrictlevels.Twoprovinces havedevelopedtheirownprovincialmentalhealthpolicies,usingthenew Actasaguide. 224 Itcodifiesanumberofrightsforpeoplewithmental healthconditions,andpromotesvoluntarytreatmentandfreeandinformed consent.ItincludesoversightmechanismssuchasaMentalHealthReview Board,whichisaimedatprotectingagainsthumanrightsviolations. UN Convention obligations addressed by reform in Chile 225 TheChileanParliamenthasapprovedanimportantlawontheSocial IntegrationofPersonswithDisabilityinFebruary2010,makingitoneofthe firstcountriestoreformitslegislationinlinewithitsobligationsundertheUN ConventionontheRightsofPersonswithDisabilities(CRPD). Highlightsofthenewlegislationinclude: • Equalrightsforpeoplewithmentaldisability • Therightforpeopletobuildandbepartofafamily,aswellastotheir sexualityandreproductivehealth • ProtectionbytheStateagainstviolence,abuseanddiscrimination • Therighttorefusetreatment • Therighttoliveindependentlyandinthecommunity • Therighttoaccessrehabilitationservicesbasedinthecommunity • Therighttoreceivesubsidiestobuyahome • Therighttoeducationtakingintoaccountspeciallearningneeds • Therighttopaidemployment 50 MentalHealthandDevelopment:Targetingpeoplewithmentalhealthconditionsasavulnerablegroup
Box 16 Governments can also be encouraged to establish independent mechanisms, such as visiting committees, to monitor conditions in mental health facilities. Such committees provide a critical function in many developed countries by ensuring that conditions are acceptable, residents are receiving appropriate care, and human rights are being respected. 49 Box 16 summarizes examples of such committees’ actions in Ireland and the United Kingdom. Country experiences: monitoring mental health facilities TheMentalHealthCommissionofIreland,anindependentstatutorybody, wasestablishedin2002asaresultofprovisionsinIreland’sMentalHealth Actof2001.In2007,theCommissionestablishedaformalinquiryintothe useofseclusionandrestraintsintwohospitals.Theinquiryledtoareport thathighlightedseriousconcernsaboutthequalityofmentalhealthcarein thesefacilities. 226Itdrewattentiontoaspectsofserviceprovisionthatwere “totallyunacceptableinamodernmentalhealthservice.”227 • Onthestrength ofthesefindings,theHealthServiceExecutive(HSE)ofIrelandformulateda detailedimplementationplantoaddressthereport’srecommendations.The implementationplanincludesthedevelopmentofnewcommunity-based facilities,tobefundedfromthesaleofhospitallands. • In2005,theHealthCommissionandtheCommissionforSocialInspection (CSCI)jointlyinvestigatedtheCornwallPartnershipNationalHealthService Trust(CPT)ofEngland,UnitedKingdom,followingreportsofhumanrights violationsamongpeoplewithintellectualimpairmentswhowerelivinginthe Trust’sresidentialfacilities.Theinvestigatingteamfoundevidenceof“staff hitting,pushing,shoving,dragging,kicking,secluding,belittling,mocking andgoadingpeoplewhousedtheTrust’sservices,withholdingfood,giving coldshowers,overzealousorprematureuseofrestraint,poorattitude towardspeoplewhousedservices,pooratmosphere,roughness,carenot beingprovided,alackofdignityandrespect,andnoprivacy.”Their2006 reportreceivedwidespreadmediaattention,andledtothesuspensionor dismissalofsomestaffmembersandthe eventualclosingofthehospital wheremanypeoplewithintellectualimpairmentslived. Careofresidents wastransferredtotheCornwallCountyCouncil’sadultsocialcareteamand tocharities. 228 Asanoutcomeofthe2006report,lawyersareintheprocess ofgatheringevidencefromupto400formerresidentstolauncha£2million groupactionlawsuit. 229 4.Improvingdevelopmentoutcomes:principlesandactions 51
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MENTAL HEALTH AND DEVELOPMENT: Targ
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WHOLibraryCataloguing-in-Publ
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Executive summary . . . . . . .
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This report on mental health and de
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Association for Mental Health and A
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Supporting statements H.R.H. Prince
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promotes a holistic approach to men
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affect them, including development
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event drives vulnerable individuals
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Supportingstatements response to
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Supportingstatements Gerard Quin
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Supportingstatements The Ministr
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Supportingstatements The report
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Executivesummary Two development
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Page 35 and 36: 1.Introduction People with menta
Page 37 and 38: 1.Introduction community, to ens
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Page 45 and 46: In many countries, people cannot co
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Page 49 and 50: Some country examples: • In Argen
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Page 67 and 68: 4.2 Specific actions Specific progr
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Page 97 and 98: References References 1 Reducing po
Page 99 and 100: References 46 South Central Somalia
Page 101 and 102: References 93 Alonso J et al. Popul
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Page 105 and 106: References 192 What works! Employme
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