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Torture and ill-treatment in psychiatry

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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Torture and ill-treatment in psychiatry

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  1. Torture and ill-treatment in psychiatry Tina Minkowitz

  2. 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

  3. Concerns • 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”

  4. 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

  5. “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

  6. 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

  7. Recommendations • 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

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