WNUSP releases statement on the Implications of the CRPD on Forced Treatment

Statement of the World Network of Users and Survivors of Psychiatry

Spanish: Comunicado RMUSP sobre CDPD y Tratamiento Forzoso final (download)

Position Paper on the Implications of the CRPD

March 14, 2011

World Network of Users and Survivors of Psychiatry, the global democratic organization representing persons with psychosocial disabilities, contributed actively to the drafting and negotiation of the CRPD.  WNUSP contributed proposals of text that were incorporated into the treaty, made extensive comments on major drafts that went into the initial compilation and on the successive drafts of the working text, and provided information and analysis from the perspectives of law, policy, and lived experience.  WNUSP provided an expert to the working group of 40 individuals that met to draft the first official text, and represented our global constituency on the steering committee of the International Disability Caucus, which collectively spoke for the community of persons with disabilities and allied NGOs participating in the Convention process.

Since the conclusion of negotiations, WNUSP has continued to contribute to international implementation and monitoring.  Two WNUSP members now serve on the Committee on the Rights of Persons with Disabilities.  WNUSP experts have spoken on panels at the Conference of States Parties and in the CRPD Day of General Discussion on Article 12.  WNUSP, together with other members of the International Disability Alliance, has developed position papers on legal capacity and on the CRPD in relation to other provisions of international law and has contributed to OHCHR consultations.  WNUSP has contributed significantly to the development of international law on torture and persons with disabilities, providing expertise to OHCHR, the Special Rapporteur on Torture, and the Subcommittee for Prevention of Torture, and is a member of the OPCAT Contact Group.  WNUSP leads a working group on legal capacity that operates list-serves in both English and Spanish.

WNUSP celebrates the CRPD as a revolutionary articulation of our equal rights and dignity as human beings.  Users and survivors of psychiatry everywhere are not only discriminated against by communities that see us as cursed or as having defective brains; we are deliberately excluded from equal protection under the law.  In many countries we are deemed to lack legal capacity and treated as civilly dead; in other countries we are individually vulnerable to deprivation of legal capacity if a judge believes we are unable to act in our own best interests.  Our members are imprisoned in medical hospitals and institutions and in religious temples, cutting short their opportunities to develop a life of their own choosing and perpetuating segregation that reinforces negative stereotypes, leading to further discrimination.  Violent medical practices like forced electroshock, forced drugging, restraint and solitary confinement continue to be practiced, along with violent traditional/religious practices, in people’s own homes as well as in institutions, causing trauma that is unacknowledged as such in our communities, since it is done in the name of therapeutic treatment.   Many people experience madness or are labeled as mad after being traumatized by serious acts of violence and abuse or other disasters; their needs go unmet and are exacerbated by a mental health system based on diagnostic labeling and subjection of the mind and body to forced interventions.

WNUSP interprets the CRPD as necessarily prohibiting compulsory treatment and detention in psychiatry.  The CRPD guarantees to us health care based on free and informed consent, on an equal basis with others, and it is well established that a corollary of the right to free and informed consent is the right to refuse treatment.  The right to control our own bodies is an aspect of the right to respect for physical and mental integrity (related to the inherent dignity of the human being), as well as an aspect of the right to health, and both rights are guaranteed on an equal basis with others by the CRPD.  Detention based on the existence of a disability is prohibited:  we agree with the UN Office of the High Commissioner for Human Rights that this prohibition extends to deprivation of liberty on the grounds of mental illness plus some other factors to which it may be linked in legislation, such as “danger to self or others” or “need for care and treatment”.  The negotiating history, in which we took part, shows that states rejected proposals to open the door to such linked grounds for detention by prohibiting only detention based “solely” on disability.  The Chair conducting negotiations summarized the discussion on Article 14.1(b) by saying “This is a pure non-discrimination provision.  Persons with disabilities who threaten others should be dealt with in the same manner as other persons.”  The CRPD further provides that persons with disabilities have the legal capacity to make decisions in all aspects of life, including decisions about medical treatment and hospitalization, so that substitute decision-makers cannot step in to impose treatment or confinement on a person against his/her will. 

The CRPD text on legal capacity is a microcosm of the paradigm shift embodied in the CRPD as a whole.  Instead of restricting autonomy of those who need extra support to comfortably participate in all aspects of life, the CRPD requires states to provide access to such support and respect the autonomy of all persons with disabilities.  This not only sets out a legal standard, it also stands as a model for mental health services and for supports outside the mental health system that need to be made available to all persons experiencing madness, mental health problems or trauma at any time in their lives. 

WNUSP recognizes that controversy has arisen with respect to these interpretations of the CRPD, and that some states have gone so far as to make interpretive declarations to the effect that the CRPD permits substituted decision-making and compulsory treatment.  In our opinion, the interpretations we set out are supported by the plain meaning of the text and reinforced by the principles set out in Article 3 to guide interpretation.  If the plain meaning of any of these provisions is ambiguous, the first question must be, what reading of the text most supports the respect for individual autonomy, non-discrimination, respect for human diversity and full and effective participation and inclusion? 

In the case of Article 12, it must be recognized that legal capacity on an equal basis with others means the same legal capacity as others – not an inferior or partial legal capacity or a presumption of legal capacity that can be rebutted by evidence of lack of sufficient decision-making ability.  One person’s judgment that another lacks decision-making ability is tantamount to negating the human subjectivity of that person; such judgments if probed are based on an attribution of psychosocial, intellectual or other mental (such as dementia) disability.  Support must be provided to the full extent of a person’s need, but must never become compulsion; support for the exercise of legal capacity can never subvert legal capacity itself, which is the right to make one’s own decisions. 

WNUSP and our related networks have developed robust alternative models for a social response to persons experiencing madness, mental health problems and trauma.  These models emphasize the primacy of first-person experience, honoring thoughts and feelings, meeting practical needs, taking enough time for resolution or healing, and believing in every person’s ability to transform his/her life.  Professional psychotherapy, nutrition and other holistic therapies, and psychiatric treatment with drugs, can be a valid part of an individual’s healing journey when used with free and informed consent.  Free and informed consent practices should be geared to giving individuals the tools to make decisions they are comfortable with now and are not likely to regret later; their primary purpose is not to protect medical personnel from liability.  The serious adverse effects associated with psychiatric drugs in particular, including increased potential for metabolic problems and early mortality, indicate that safer alternatives should be researched and developed, and that existing drugs should be carefully scrutinized for safety and efficacy with accountability to users.  A consensus is developing in our community that electroshock, in its modified or unmodified forms, as well as any kind of psychosurgery, is too risky and should not be used at all.

Spiritual and traditional healing/therapies may have great value for individuals and communities, affirming their connections to one another and the transformative potential of madness, so long as it is not forced or coerced.  Forced or coerced participation in spiritual and traditional practices, like forced medical interventions, can amount to torture or ill-treatment.

The success of alternative models indicates that resistance to the full implications of the CRPD is primarily the result of discrimination that persists despite the advances made in human rights law and in the development of practical knowledge.  WNUSP calls on states to develop inclusive processes for implementation of the CRPD in the manner of the drafting and negotiations, with a central role for users and survivors of psychiatry and other persons with disabilities, coming together in good faith to transform society and its laws and practices for our full inclusion and equality.  Users and survivors of psychiatry are the primary agents and primary beneficiaries of this transformation but it is one that ultimately involves and benefits everyone.

If you individually or as an organisation support the WNUSP statement on the Implications of the CRPD on Forced Treatment, please enter your details into the text boxes and click SUBMIT.

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The undersigned endorse the statement by World Network of Users and Survivors of Psychiatry and its position that the CRPD prohibits compulsory mental health treatment and mental health detention.

Prateeksha Sharma
Executive Director at Hansadhwani Foundation
www. hansadhwani.org (being a nascent organization, website is under construction) Hansadhwani works in mental wellness through the arts- performing and visual arts. I who is the founding head of the organization am a psychiatric survivor myself (having being labelled \'bipolar\' for the last over 18 years) The whole idea behind our organization is to help people train their minds in a manner that would make art a means to their self-expression and mental well-being. We are based out of New Delhi, India

Aileen Lemoine

Irene Lynch
CEO at ALEPPOS Foundation

Dana Johnson
Psychiatric survivor

Juhani Weijola

Becky Murphy

Lasse Bøyum

Robin Hammond
Freelance Photojournalist

Dmitry Vengerovsky

Association for the Protection against Psychiatric Violence

Sonya Mann

Kay Hughes

Sigrun Toemmeraas

Member of We Shall Overcome (WSO)

Rebecca Mayer

Joan Mackie

David M Gofton

Karl Bach Jensen
Development officer at LAP - National Ass. of Users and Ex-users of Psychiatry, Denmark

Euroepan Networtk of (ex-) Users and Survivors of Psychiatry

Iñaki Regueiro De Giacomi
Red por los Derechos de las Personas con Discapacidad (REDI), Argentina

Iris Hölling
Member at Association for the Protection of Psychiatric Violence Berlin

Richard Patterson
Activist at A Bit Mad Ted
Website: [ www.abitmadted.blogs.ie ] / YouTube: [ itsabitmadted ]

Maria Graciela Iglesias
docente- Magistrada, Universidad-Poder judicial

Mercedes Torres Lagarde
www.cmdpdh.org Human Rights Stretgic Litigation non governmental organization

Colin Slade

Keren Parnell

Piers Gooding
Ph.D Candidate
Melbourne, Australia

Larry E. Roberts
Ithaca Mental Patients Advocacy Coalition, Ithaca, NY, USA

Delores M. Jankovich

Erveda Sansi
Deputy board member at European Network of (ex) -users and survivors of Psychiatry

Anna Gartshore, MSW, RSW

Social Worker - Child & Adolescent Mental Health at Sault Area Hospital

Edward Knight, PhD
Sole Proprietor at Ed Knight Consulting

Irma Fernandez

Isaac S. Brown
CEO at Baltic Street AEH Inc.

Rhonda Thomas
I am an artist and a psychiatric survivor, living with permanent injuries due to lithium poisoning in Arizona, USA. Currently, I am making new art works that are anit-psychiatry in nature.

Greg White
Mindfreedom Ireland

Beth Filson
Independent Consultant for the National Association of State Mental Health Program Directors and for National Center for Trauma-Informed Care
nasmhpd.org and samhsa.gov/nctic

Barrie Lafortune
Parent of person forced to take psychiatric \'medications\'that had terrible side effects both physically and psychologically.

Hélène Grandbois
Mindfreedom international
I have no decision making in the organization but I am quite sure they would endorse your statement David Oaks that you probably already know is the contact person and ECT Loretta Wilson is a good person to know.

Darby Penney
President at The Community Consortium
www.community-consortium.org; www.suitcaseexhibit.org

Bryhre K. Cormack
Heartsense Counselling and Consulting

Richard Patterson

Mary Maddock
Founder member MFIreland/boardmember MFInternational
www.mindfreedomireland.com www.mindfreedom.org
I strongly support No Force. Thanks for setting this petition up. I will encourage others to sign.

Rev. Heather Cherry

Tiffany A. Phillips

Ruth Needham

Vince Boehm

Harvey Rosenthal
Executive Director at New York Association of Psychiatric Rehabilitation Services

Sonia K Weaver

Julian O\'Neill

Eleanor Forman

Gianna Kali
Author/Editor at Beyond Meds

Erica Wexler

Nathen Schumann

Nancy Rubenstein

Director of Public Education at PsychRights.org

Teresa McLain
Executive Director at Wise Women Laughing
We are aware that battered women who seek psychiatric support have often been labeled crazy by the psychiatrists, based on the behavior the women manifest as a result of being the target of extreme domestic violence. This discounts these women and makes them more vulnerable to the domestic violence, and isolates them from social support, since they are no longer believed. This adds the torture of psychiatric abuse often experienced by these women labeled crazy, to the long-term, ongoing torture they experience as battered wives. Also, the labelling psychiatists are not labelling the women based on objective facts, but on the discriminatory, sexist idea that women who no longer act submissive in the face of domestic violence, but assert that they do not want to be further tortured, raped, terrorized or threatened with murder, nor do they want their children subjected to this violence in their formative years, are crazy, because a "normal," "sane" woman would act passive and submissive, no matter whether to do so would lead to her and her childrens' continuted injury and death.

Mary S Newton, PhD

Charleston, SC USA

Duane Sherry, M.S.
Texas, USA
Forced treatment needs to stop! A vison to transform the mental health system, in the United States, and around the world - http://discoverandrecover.wordpress.com/mental-health-freedom-and-recovery-act/

Marty Felker
Voting member at SWVA Policy Board for Regional Planning

Carole Hayes Collier

Graeme Bacque

Vicky Pullen

John Lhombreaud
Member at New Horizons Borders
I support the WNUSP statement on the implications of the CRPD on forced treatment. It is a disgrace.

Jasna Russo

Muhannad Alazzeh
Team Leader of the Disability Rights Component in the Civil Society Program, Board member in the Board of Trustees in the National Center for Human Rights
Civil Society Program - Jordan, the National Center for Human Rights - Jordan

Diana Signe Kline

Myra Kovary

Lester Cook
Executive Director at Dreamweaver\'s Peer Support, Inc.

Daniel Hazen
Executive Director at Voices of the Heart inc.

Sheila Cooper
Member at People Who

Sylvia Caras
President at People Who

Naphtali Titus Chondol
psychiatric survivor advocate forced treatment
I am very passionate of challenging the medical model of psychiatry. Mental issues are all about SPIRITUAL MATTERS period. I speak from volumes of experience. ONLY THE LIVING GOD CAN HEAL THE broken MIND.

Amanda Stella

Raja Abdullah Almasabi
Chairwoman at Arab Human Rights Foundation
www.ahrf-ye.org - our we is under mintinance

Judy Gayton

Psychiatric survivor, Canada

Belpaire Pierre

Belinda Jane

Huub Beijers

Manager at Steunpunt GGZ Utrecht


Center for the Human Rights of Users and Survivors of Psychiatry

Community Consortium, Inc.

Dreamweaver’s Peer Support Inc.

Law Project for Psychiatric Rights

Mind Freedom International

We Shall Overcome

We The People

Tina M. Bonneau

Debbie Kay Calkins

Lester Cook

Gina DeLuca
Ithaca, NY
I am a 48 year old mother and grandmother who is a psychiatric survivor; I have also worked at a peer run agency for nearly twenty (20) years, and am retired.

Hélène Grandbois

Piotr Iwanejko

Jeff Makana

Gregory Dale Oke

Margaret J. Park, M.Div.
Psychiatric Survivor/Ex-patient
Pittsburgh, PA

John McCarthy, Mad Pride Ireland/WNUSP/MindFreedom

Craig Newnes, Director of Psychological Therapies, Editor, Author, Survivor and Human Rights Award winner (2005)

Debra Shulkes, European Network of (ex-)Users and Survivors of Psychiatry (Deputy board member)

Joann J. Smith

Lauren Tenney, PhD candidate, MPhil, MA, MPA, Psychiatric Survivor

Jan Wallcraft

David Webb, PhD and psychiatric survivor
Melbourne, Australia