CRPD-Psychosocial

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					The Rights of Users and Survivors of Psychiatry
                      and
The United Nations Convention on the Rights of
       Persons with Disabilities (CRPD)



                 A conversation with David Webb
          psychiatric survivor and human rights advocate
                                  &
                            Lesley Hall
    CEO, Australian Federation of Disability Organisations (AFDO)

                            Friday April 23rd, 2010
                 The Psych Action and Training Group, (PAT)
            Centre for Psychiatric Nursing, University of Melbourne


Australian Federation of Disability Organisations
                 CRPD Pre-History
   1982 – UN adopts the World Programme of Action
    concerning Disabled Persons
   1983-1992 - UN Decade of Disabled Persons
   1987 – first (failed) attempt to recommend a convention
    on the human rights of persons with disabilities
   1991 – UN adopts the “Principles for the protection of
    persons with mental illness and the improvement of
    mental health care” (MI Principles)
   1993 – UN adopts the “Standard Rules on the
    Equalization of Opportunities for Persons with
    Disabilities” (the Standard Rules).
    Australian Federation of Disability Organisations
                       CRPD History

   December 2001 – Mexico proposes an international
    convention on the rights of persons with disabilities.
   August 2002 – first session of the Ad Hoc Committee
   25 August 2006 – eighth session of the Ad Hoc
    Committee finalises text of CRPD
   13 December 2006 – UN adopts by consensus the
    Convention on the Rights of Persons with Disabilities
   30 March 2007 – The Convention and Optional Protocol
    opened for signing at UN Headquarters in New York.
   3 May 2008 – entry into force

    Australian Federation of Disability Organisations
         CRPD a “paradigm shift”
Old paradigm:
 medical model
 pwd as objects of pity deserving charity
 protective, patronising, “father knows best”
 substituted decision-making
New paradigm:
 social model
 pwd as subjects with dignity and autonomy
 autonomy, social inclusion, rights based
 supported decision-making

    Australian Federation of Disability Organisations
         Social Model of Disability

CRPD preamble:
“disability results from the interaction between persons with
impairments and attitudinal and environmental barriers that
 hinder their full and effective participation in society on an
                     equal basis with others”

   disability is not an attribute of the person
   disability is discrimination (stigma) against persons with
    “impairments” by a non-inclusive society
   disability is primarily a human rights issue

     Australian Federation of Disability Organisations
                 Structure of CRPD 1
Preamble                                   12. Equal recognition before the law
1. Purpose                                 13. Access to justice
2. Definitions                             14. Liberty and security of the person
3. General principles                      15. Freedom from torture or cruel,
4. General obligations                        inhuman or degrading treatment or
                                              punishment
5. Equality and non-discrimination
                                           16. Freedom from exploitation, violence
6. Women with disabilities
                                              and abuse
7. Children with disabilities
                                           17. Protecting the integrity of the person
8. Awareness-raising
                                           18. Liberty of movement and nationality
9. Accessibility
                                           19. Living independently and being
10. Right to life                             included in the community
11. Situations of risk and
   humanitarian emergencies

       Australian Federation of Disability Organisations
                 Structure of CRPD 2
20. Personal mobility                           29. Participation in political and
21. Freedom of expression and                      public life
   opinion, and access to                       30. Participation in cultural life,
   information                                     recreation, leisure and sport
22. Respect for privacy                         31. Statistics and data collection
23. Respect for home and the family             32. International cooperation
24. Education                                   33. National implementation and
25. Health                                         monitoring
26. Habilitation and rehabilitation             34 to 40. International monitoring
                                                   mechanism
27. Work and employment
                                                41 to 50. Final clauses
28. Adequate standard of living and
   social protection                            Optional protocol




       Australian Federation of Disability Organisations
               Psychosocial disability
One person, many labels:
      psychiatric survivor
      mental health consumer
      mental health service user (UK)
      person with psychiatric disability
      person with mental disability (yuk)
      person who experiences psychosocial disability
      mad, crazy, loopy, wacko nutter …

      Australian Federation of Disability Organisations
                Article 12
     Equal recognition before the law
    “persons with disabilities enjoy legal capacity on an equal
             basis with others in all aspects of life”
  [countries] “shall take appropriate measures to provide
access by persons with disabilities to the support they may
         require in exercising their legal capacity”
    key principle of CRPD is prohibition of discrimination on
     the basis of disability (includes medical status)
    legal capacity – the right to make your own decisions
    Article 12 represents the foundation of paradigm shift
     from substituted to supported decision-making
      Australian Federation of Disability Organisations
              Substituted vs
         Supported Decision-Making
Substituted:
   someone else decides on behalf of another
   with or without their consent
Supported:
   every effort made to ascertain a person’s wishes
   support to make decisions and/or communicate them
   obligation to respect the person’s wishes
   right to take risks “on an equal basis with others”

     Australian Federation of Disability Organisations
           Australia and the CRPD
   17 July 2008 – Australia ratifies CRPD but makes 3
    “interpretive declarations”, including this on Article 12:

    Australia recognizes that persons with disability enjoy
    legal capacity on an equal basis with others in all
    aspects of life. Australia declares its understanding that
    the Convention allows for fully supported or substituted
    decision-making arrangements, which provide for
    decisions to be made on behalf of a person, only where
    such arrangements are necessary, as a last resort and
    subject to safeguards


     Australian Federation of Disability Organisations
         Australia and the CRPD
... and this on Article 17, explicitly mentioning “mental
disability” ...
  Australia recognizes that every person with disability
  has a right to respect for his or her physical and mental
  integrity on an equal basis with others. Australia further
  declares its understanding that the Convention allows
  for compulsory assistance or treatment of persons,
  including measures taken for the treatment of mental
  disability, where such treatment is necessary, as a last
  resort and subject to safeguards


   Australian Federation of Disability Organisations
         Does the CRPD prohibit
       substituted decision-making?
   in Australia we mostly hear it assumed that the CRPD
    permits substituted decision-making … but …
   this is controversial and contested around the world
   at the very least, it’s still an open question
   Article 12 is considered central to the “object and
    purpose” of the CRPD – invokes Article 46
   CRPD Committee has set up a working group to
    develop a General Comment on the interpretation of
    Article 12


     Australian Federation of Disability Organisations
            The Limitation of Rights
   not mentioned in the CRPD
   other human rights laws do:
    • ICCPR, Victoria’s Human Rights Charter
    • criteria exist for when the limitation of a right can be
      lawfully justified (Syracusa Principles):
       – “can be demonstrably justified in a free and
         democratic society” (Victoria’s Human Rights Charter)
       – “reasonable, necessary, justified and proportionate”
           (Victorian Equal Opportunity and Human Rights Commission)
       –   e.g. criminal justice systems

     Australian Federation of Disability Organisations
          Victoria and the CRPD

Guardianship Act
  • approx 1,300 people, mostly age-related dementia
  • currently under review by Law Reform Commission

Mental Health Act
  • 5,000+ on Involuntary Treatment Orders
  • each week in Victoria, over 100 involuntary patients
    are given ECT
  • currently under review by DHS !!!

   Australian Federation of Disability Organisations
            Victoria and the CRPD
   review of Mental Health Act nearly over
   government has announced it intends to maintain
    substituted decision-making
   but the DHS have not (yet?) presented any justification
    for this decision – as required under the Charter

   also ... Disability Act (2006) discriminates against people
    who experience psychosocial disability !




     Australian Federation of Disability Organisations
                          Conclusions

   CRPD (and Charter) are great advocacy tools
   but by themselves do not eliminate legally sanctioned
    prejudice and discrimination
   the challenge now is awareness raising (Art 8) and
    implementation and monitoring (Art 33)


    Nothing About Us Without Us
                         www.un.org/disabilities
                           www.afdo.org.au
    Australian Federation of Disability Organisations

				
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posted:9/23/2011
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