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Torture and ill-treatment in psychiatry. Tina Minkowitz. Welcome “absolute ban”. Absolute ban on nonconsensual psychosurgery, electroshock, mind-altering drugs including neuroleptics , restraint and solitary confinement long- and short-term

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welcome absolute ban
Welcome “absolute ban”
  • Absolute ban on nonconsensual psychosurgery, electroshock, mind-altering drugs including neuroleptics, restraint and solitary confinement long- and short-term
  • Replace forced treatment and commitment with services that meet expressed needs, respect autonomy, alternatives to medical model
  • CRPD as authoritative guidance
  • Treatment that violates CRPD cannot be justified as medical necessity
  • Revise contrary legal provisions
  • Contradiction with CRPD in paragraph 69, impacts on recommendations
  • “Necessity to protect the person or others” is a red herring and masks the discriminatory and violent character of detention based on “mental illness” or “unsoundness of mind”
  • Lack of clarity re legal capacity and informed consent in paragraphs 27 and 66, CRPD does away with “incapacity”
civil commitment detention
Civil commitment/detention
  • CRPD prohibits all forced and coercive interventions in mental health services, including civil commitment/detention
  • Mandate formerly recognized that psychiatric detention was within the scope of acts causing severe pain and suffering
  • Mandate in current report unqualifiedly rejects detention of drug users
danger to self or others
“Danger to self or others”
  • Standard created to justify psychiatric detention
    • Part of MI Principles, overruled by CRPD
  • Labeling any person as dangerous is character assassination, unjustifiable and arbitrary
  • Psychiatric profiling and other profiling
how do we respond to suicide and violence
How do we respond to suicide and violence?
  • Non-discriminatory standards, larger social conversation – not about “mental health”
  • Preventive detention too serious an infringement on human rights, causes suffering and violence, not a solution
  • Intervening to stop an act of violence or suicide is not the same as detention
  • Safe spaces to explore suicidal feelings or intent – detention is not a safe space
  • Uphold CRPD standards requiring the repeal of civil commitment and incapacity/ substituted decision-making
  • Publicize and implement absolute ban on nonconsensual psychiatric interventions, and obligation to replace forced treatment and commitment by services that respect autonomy
  • Raise awareness about psychiatric profiling and its relationship to civil commitment, explore safety, mutuality and autonomy