The following statement was submitted by the World Network of Users and Survivors of Psychiatry (WNUSP) to the United Nations Committee on the Rights of Persons with Disabilities (UN CRPD Committee) for its Opening session on 8 March 2021. Due to the time limits in the virtual session, the opportunity to present the statement has been rescheduled to the Closing session of the UN CRPD Committee on 1 April 2021 at 14.30, which can be followed through http://webtv.un.org/
The Opening session of the UN CRPD Committee of 8 March 2021 can be watched here: UN Live United Nations Web TV – Opening of Session – 522nd Meeting, 24th Session Committee on Rights of Persons with Disabilities
WNUSP statement for UN CRPD opening session, 8 March 2021
The World Network of Users and Survivors of Psychiatry, in short WNUSP, is an organization run and governed entirely by users and survivors, and is the only independent, global, grassroots organization of persons with psychosocial disabilities. WNUSP advocates for the human rights of persons with psychosocial disabilities worldwide.
WNUSP thanks the Committee for the opportunity to take the floor. WNUSP would like to express its gratitude and full support to the work this Committee is undertaking on de-institutionalization.
There is a human rights emergency in mental health institutions.
The COVID19 pandemic has sharpened inequalities and has deepened human right violations.
All over the world, mental health care is nowadays stripped off from the gains of past decades in terms of the availability of supportive therapies, social activities, leaves and visits. The core character of institutional settings have reverted back to confinement and medication, as if the mental health system lapsed back into the past century. The situation is even worse in places where the availability of supportive therapies in institutions had never been realized even before the pandemic, and in numerous places the the living conditions of persons in institutions are horrendous, with groups of people confined in degrading conditions, even lacking basic hygiene measures.
Even before the pandemic, there was a pre-existing human rights emergency in many institutions, with numerous practices amounting to torture and ill-treatment, including large scaled preventative and arbitrary detention, the administration of mind-altering medication without consent, seclusion and restraint, even cage beds in some countries, and forced ECT (electro-convulsive-therapy). On top of that there have been repetitive scandals in the mental health sector of e.g. exploitation, unbearable neglect, and systematic sexual abuse, as well as persistent complaints about the harm done by psychopharma. In addition, the staff in institutions is usually tasked with arranging the institutional routines and has generally little time for individualized personal support. Even before the COVID19 pandemic the situation in the mental health care sector demanded urgent remedy. Even before the pandemic, there was a call to abolish such institutions, and abolish forced treatments and any other practices which cause suffering and do not amount to recovery or wellbeing.
The COVID19 pandemic doubled the emergency
Considering that the mental health institutions were already unable to really meet the needs of the residents, further constraints are obviously taking a horrible toll. The measures such as lockdown made existing atrocities worse. (also see COVID19 Disability Rights Monitor report)
Confinement, regimes of overmedication, minimized human contact, no social visits and no monitoring. At the same time there is an increased contraction risk due to staff rotations, and an increased mortality risk. While the situation inside these mental health institutions is worse than ever, the decision was made to lock the doors, leave these people fully on their own in dangerous situations, unable to leave, and without monitoring. In all those months of lockdown measures, the people in institutions suffered the most by far. Their lives have been frozen, while they were stuck at the bottom.
Deinstitutionalization is necessary especially during the pandemic
The only right thing to do now, is to make real and sustainable efforts to secure the rights of persons with disabilities. Overall this starts with protecting the very lives and basic living conditions. Practical tools and methods to achieve better living conditions are deinstitutionalization, ending forced treatments (including ending forced medication, ending Community Treatment Orders), involving persons with lived experience in the design and planning and transformation of services. The UN Convention on the Rights of Persons with Disabilities (UN CRPD) offers a full set of human rights standards to be implemented.
Also community based support services are impacted by lockdown measures and limitations.
The pandemic is overshadowing lives everywhere in the world. WNUSP is deeply concerned about the increased inequalities in the community, including increased poverty, food insecurity, job insecurity, domestic violence, social isolation and much more. These are all circumstances which can lead to psychosocial disabilities. These social injustices need to be remedied at the community level, by structurally addressing inequalities, and leaving nobody behind, and foster mental health and wellbeing for all.
Both mainstream and specific support services have shown to be subject to lockdown and other COVID19 restricting measures under national policies, leading to largescaled inaccessibility and decreased qualilty of support services for persons with psychosocial disabilities. People from all layers of the community, including youth, suffer from the COVID19 controlling measures, by social isolation and burden of insecurities, leading to an increase of psychosocial disabilities. Testimonies show increased depression and suidice risks, addiction, suffering. Yet personal support options are very limited throughout. WNUSP does notice an increase of support provided through modern communication tools, which provides new possibilities, yet this may not be accessible for everyone. Besides that, the virtual and remote support may not fit everyone, as it cannot fully replace face to face contact or personal contact, where e.g. presence may play a role.
Realizing psychosocial support must be prioritized
To remedy the lack of support for psychosocial disabilities throughout, it is needed to realize access to a full range of community based support services, and to consider mental health a vital part of health. The WHO constitution states: “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” Yet, while tireless efforts are made to enable medical support during the COVID19 pandemic, only little efforts are made to protect the psychosocial health of the population, or to support persons with psychosocial disabilities in their needs. Instead, WNUSP is witnessing on the one hand increasing psychosocial needs throughout the population, and on the other hand a deterioration of existing support systems. This is an unacceptable neglect of the right to health, and has to be remedied. Psychosocial wellbeing is a vital component of the health of everyone.
Another point of concern is the triage for COVID19 related and life saving support, which is in many cases discriminatory to persons with disabilities, including persons with psychosocial disabilities. The right to life on an equal basis with others is at stake.
To conclude, both inside institutions and in the community, persons with psychosocial disabilities suffer very severe consequences of the COVID19 pandemic, and are in many places left stuck at the bottom without support. On top of that, there is a lack of monitoring, and a lack of remedying existing human rights violations.
Urgent actions need to be taken to end the injustices and neglect towards psychosocial disabilities, and to realize community based support for anyone with psychosocial disabilities.
As a final note, WNUSP would like to request the UN CRPD Committee to take action against the Draft Additional Protocol to the Oviedo Convention, as well as taking action in regards to the Council of Europe Article 5.1.e of the European Convention of Human Rights which should be amended by the provisions of UN CRPD Article 14, as is presented by the European Network of Users, (Ex)Users and Survivors of Psychiatry (ENUSP).