Human Rights of the Persons With

Mental Health Conditions : A Review

M.Phil 1st Year ,Clinical Psychology Center of University of Calcutta

Presented by Sudhanya Roy Chowdhury

Supervised by Soheli Datta
 Outline
• Introduction
• Mental health and inequity: A human rights approach to
inequality, discrimination, and mental disability.
• Timeline of Mental Health Legislation
• India’s mental health legislation
• THE MENTAL HEALTHCARE ACT, 2017
• Human Right Violation in Mental health
• Mental health advocacy
• Stakeholders in mental health advocacy
• Conclusion
 Introduction
• Mental disability and mental health care have been neglected in the
discourse around health, human rights, and equality. This is perplexing as
mental disabilities are pervasive, affecting approximately 8% of the
world’s population. (WHO,2009) Furthermore, the experience of persons
with mental disability is one characterized by multiple interlinked levels of
inequality and discrimination within society. Efforts directed toward
achieving formal equality should not stand alone without similar efforts
to achieve substantive equality for persons with mental disabilities.
Structural factors such as poverty, inequality, homelessness, and
discrimination contribute to risk for mental disability and impact
negatively on the course and outcome of such disabilities. A human rights
approach to mental disability means affirming the full personhood of
those with mental disabilities by respecting their inherent dignity, their
individual autonomy and independence, and their freedom to make their
own choices
Mental health and inequity: A human rights approach to
inequality, discrimination, and mental disability

A rights-based approach requires

• to examine and transform the language, terminology, and

models of mental disability that have previously prevailed,
especially within health discourse.

• also requires to examine the multiple ways in which

inequality and discrimination characterize the lives of
persons with mental disabilities and to formulate a
response based on a human rights framework
 Terminology and models of mental disability

• Terms such as “mental disease” and “mental

disorder” construct psychological,
emotional, and behavioral conditions as
innate, biological, pathological states
independent of socioeconomic, cultural,
and political context.
• the prevailing medical model of mental
disability — which defines disability as an
individual’s “restriction in the ability to
perform tasks” and handicap as “the social
disadvantage that could be associated with
either impairment and/or disability” —
serves to establish a direct causal
relationship between individual impairment
and disability. (Bury, 1998 ).
• In contrast, the social model of disability,
theorized by disabled activist and scholar
Michael Oliver, views disability as
something imposed upon persons by an
oppressive and discriminating social and
institutional structure and that is over and
above their impairment.
• Multiple levels of inequality and
discrimination
 A rights-based approach to mental
disability needs to be informed by a
clear analysis of the multiple levels
of inequality and discrimination that
exist in relation to individuals with
mental disabilities both within and
outside the health system. In a sense
then,
 A “situation analysis” is required to
illustrate the clear links that exist
among social, economic, political,
and cultural aspects of the
environment and the origin,
personal experience, and outcome of
mental disabilities.
The following discussion details how
substantive inequality and discrimination
characterize the manifestation and
experience of mental disability in society
as well as the provision of mental health
care-
1. Unequal prevalence due to structural
inequalities
2. Unequal service access due to
structural inequalities.
3. Unequal service access due to race,
ethnicity, and gender
4. Unequal service access due to a
diagnosis of mental disability.
5. Unequal funding and resource provision
for mental versus physical disabilities
• Many countries, in both high-
income and low- and middle-
income contexts, report serious
shortages of psychiatrists,
psychologists, psychiatric nurses,
and other mental health care
professionals. This inequality in
funding and service provision, in
the face of the major burden of
mental disability, represents
global discrimination against
mental disability and its care at
the level of policy makers, health
planners, and governments
A human rights approach to inequality and discrimination in relation to mental
disability
The UN Convention sets out a framework for a rights-based approach to
disability and in doing so “calls for changes that go beyond quality of care to
include both legal and services reforms” and “demands that we develop policies
and take actions to end discrimination in the overall society that has a direct
effect on the health and well-being of the [mentally] disabled.”
• “From a human rights perspective, people are entitled to live in and receive
care in the community not because it is more efficient, but because all
human beings develop their identities within social contexts, and have
rights to work and study, as well as be with family and friends.” (Alicia Eli
Yamin and Eric Rosenthal, 2005)
• Here, planning and decision-making power related to care in the community
needs to be transferred to “the individuals and communities that the health
system is supposed to serve.”
An action plan at national as well as
local levels include the following
components 5.Mental health and social services
• : reform with equitable funding for
resources, infrastructure, and program
1. The development of a strong
development
advocacy movement, led by
persons with mental disabilities. 6. Removal of barriers to health services
access encountered by persons with
2. Legislative reform to abolish
mental disabilities
discrimination, to outlaw abuse and
exploitation, and to protect 7. Removal of barriers to accessing
personal freedom, dignity, and social, family-related, accommodation,
autonomy educational, occupational, and
recreational opportunities and to full
3. Legislative reform to enforce
equality of opportunity, access, and participation for persons with mental
participation in all aspects of life disabilities.
4. Inclusion of mental disability on the 8. Service systems reform to move away
agenda of development programs from institutional care toward providing
and targets such as the Millennium treatment, care, rehabilitation, and
Development Goals reintegration within the community
 Timeline of mental health legislation
• 1945 : the UN (United Nations) was established in October
1945.Primary goals behind establishing UN are follows ----
 to promote international peace and security
 to reduce the possibility of further wars
 to articulate an intellectual and legal framework to support
the observance of human rights among member states
 to promote a culture of human rights throughout the world.
• 1948 : To achieve these goals, the Universal Declaration of
Human Rights (UDHR) was adopted by the UN General
Assembly in Paris on 10 December 1948.
 Highlights from The UDHR
 Article 1: “all human beings are born free and equal in dignity and rights.
They are endowed with reason and conscience and should act toward one
another in a spirit of brotherhood”
 Article 2 :“Everyone is entitled to all the rights and freedoms set forth in
this Declaration, without distinction of any kind, such as race, color, sex,
language, religion, political or other opinion, national or social origin,
property, birth or other status.”
While mental illness was not mentioned explicitly in the list of factors
which were not to form the basis of discrimination, it undoubtedly belongs
under the term “other status.”
• 1971: The Declaration on the Rights of Mentally Retarded Persons
• 1975 :The Declaration on the Rights of Disabled Persons
• 1979:The Convention on the Elimination of all forms of Discrimination
Against Women (CEDAW)
• 1984: The Convention against torture and other cruel, inhuman or
degrading treatment or punishment .
• 1991: UN's Principles for the Protection of Persons with Mental
Illness and the Improvement of Mental Health Care in 1991, The
first comprehensive explicit statement of the rights of persons
with mental illness .
• Key principles of UN's Principles for the Protection of Persons
with Mental Illness and the Improvement of Mental Health Care
include the following-
• Right to medication
• Right to consent of treatments
• Review cases of involuntary admission and treatment
• Right to access to medical information
• complaints , monitoring and remedies
• Mental health care in community
• 1996: WHO developed the Mental Health Care Law: Ten Basic Principles as a
further interpretation of the MI Principles and as a guide to assist countries in
developing mental health laws
• Mental Health Care Law: Ten Basic Principles(WHO,1996)
• 1. Promotion of mental health and prevention of mental disorders
• 2. Access to basic mental health care
• 3. Mental health assessments in accordance with internationally accepted
principles
• 4. Provision of least restrictive type of mental health care
• 5. Self-determination
• 6. Right to be assisted in the exercise of self-determination
• 7. Availability of review procedure
• 8. Automatic periodic review mechanism
• 9. Qualified decision-maker (acting in official capacity or surrogate)
• 10. Respect of the rule of law
• 2005: WHO Resource Book on Mental Health, Human Rights, and
Legislation which presents a detailed statement of human rights
issues which, for addressing at national level. The Resource
Book includes a detailed “Checklist on Mental Health Legislation” .
 The checklist is a companion to the WHO Resource Book on
Mental Health, Human Rights, and Legislation and its objectives
are to:
(a) assist countries in reviewing the adequacy and
comprehensiveness of existing mental health legislation; and
(b) help countries in the process of drafting new law. This
checklist can help countries assess whether key components are
included in legislation or policy, and ensure that the broad
recommendations contained in the Resource Book are carefully
examined and considered
• 2006:The UN Convention on the Rights of Persons with Disabilities .
• marks a “paradigm shift” in attitudes and approaches to persons
with disabilities. It takes to a new height the movement from
viewing persons with disabilities as “objects” of charity, medical
treatment and social protection towards viewing persons with
disabilities as “subjects” with rights, who are capable of claiming
those rights and making decisions for their lives based on their
free, and informed consent as well as being active members of
society.
• Definition of person with disability ‘all those who have long-term
physical, mental, intellectual and sensory impairments”
• The CRPD was passed by the UN General Assembly in 2006. It was
signed and ratified by India in 2007
 Mental health legislation in India

• MENTAL HEALTH LEGISLATION IN INDIA

• PREINDEPENDENCE
• 1858: The Lunacy (Supreme Courts) Act, the Lunacy
(District Courts) Act and the Indian Lunatic Asylum
Act . These acts focused on asylum-based care
• 1912: the Indian Lunacy Act was passed
• POST INDEPENDENCE
• 1950 : Indian Psychiatric Society submitted a revised
mental healthcare Bill
• 1987: the bill is fnally enacted as the Mental Health
Act in. shift from Lunatics to mentally ill person
1995: Persons with Dsability Act
The Act provides for both the
preventive and promotional
aspects of rehabilitation like
education, employment and
vocational training, reservation,
research and manpower
development, creation of barrier-
free environment, rehabilitation of
persons with disability,
unemployment allowance for the
disabled, special insurance scheme
for the disabled employees and
establishment of homes for
persons with severe disability etc.
• Important changes in 1987 Mental Health Act includs the following-
• modern terminology, shift from Lunatics to mentally ill person
• the creation of the Central and State mental health authorities
• prohibition of non consensual research,
• and simplifcation of discharge procedures
• Criticism of 1987 Mental Health Act
• It gave more emphasis to legal consideration rather than medical
care;
• its position on the family was criticized;
• and it failed to make provisions for home-based treatments, among
other matters ,
• the 1987 legislation was not in line with the UN-CRPD when it was published
in 2006.
• ..
• 2007:The CRPD was passed by
the UN General Assembly in
2006. It was signed and ratified
by India in 2007
• It specifies that “persons with
disabilities include those who
have long-term physical,
mental, intellectual, or sensory
impairments which in
interaction with various
barriers may hinder their full
and effective participation in
society on an equal basis with
others.”
• 2016: THE RIGHTS OF PERSONS
WITH DISABILITIES ACT
• The Rights of Persons with Disabilities Act 2016
is received the assent of the Indian President
on 27 December 2016 and like the IMHA it
explicitly states that its purpose is to give effect
to the UN-CRPD. The RPDA complements the
proposed IMHA and legally underpins many of
the social and economic rights of individuals
with mental illness.
• In particular, it emphasises respect for
inherent dignity, individual autonomy
including the freedom to make one’s own
choices, and independence of persons; non-
discrimination; full and efective participation
and inclusion in society; respect for diference
and acceptance of persons with disabilities as
part of human diversity and humanity;
equality of opportunity; accessibility; equality
between men and women; respect for the
evolving capacities of children with
disabilities and respect for the right of
children with disabilities to preserve their
identities.
• 2017:THE MENTAL HEALTHCARE ACT
 2017:THE MENTAL HEALTHCARE ACT

• 2017:THE MENTAL HEALTHCARE ACT

• National Mental Health Survey quoted a prevalence of 13.7% lifetime and 10.6%
current mental morbidity. To address this mammoth problem, an aspirational law was
enacted titled “Mental Healthcare Act, 2017” (MHCA 2017).
• PREMBLE
“An Act to provide for mental healthcare and services for persons with mental illness
and to protect, promote and fulfil the rights of such persons during delivery of mental
healthcare and services and for matters connected therewith or incidental thereto.”
DEFINATION OF MENTAL ILLNESS:
• “mental illness” means a substantial disorder of thinking, mood, perception,
orientation or memory that grossly impairs judgment, behaviour, capacity to
recognise reality or ability to meet the ordinary demands of life, mental conditions
associated with the abuse of alcohol and drugs, but does not include mental
retardation which is a condition of arrested or incomplete development of mind of a
person, specially characterised by subnormality of intelligence.
 RIGHTS OF PERSONS WITH MENTAL ILLNESS
(The Mental Healthcare Act, 2017)
• The Mental Healthcare Act 2017 aims to provide
mental healthcare services for persons with mental
illness. It ensures that these persons have a right to
live life with dignity by not being discriminated against
or harassed.
• RIGHTS OF PERSONS WITH MENTAL ILLNESS (The
Mental Healthcare Act 2017 )
• Right to access mental health care
• Right to community living.
• Right to protection from cruel, inhuman and
degrading treatment
• Right to information
• Right to equality and non- discrimination
• Right to confidentiality.
• Restriction on release of information in respect of
mental illness.
• Right to access medical records.
• Right to personal contacts and communication
• Right to legal aid
• . Right to make complaints about deficiencies in
provision of services
• Right to access mental health care
• (1) Every person shall have a right to access mental healthcare and treatment from mental
health services run or funded by the appropriate Government.
• 2) The right to access mental healthcare and treatment shall mean mental health services
of affordable cost, of good quality, available in sufficient quantity, accessible geographically,
without discrimination on the basis of gender, sex, sexual orientation, religion, culture,
caste, social or political beliefs, class, disability or any other basis and provided in a manner
that is acceptable to persons with mental illness and their families and care-givers.
• (3) The appropriate Government shall make sufficient provision as may be necessary, for a
range of services required by persons with mental illness.
• (4) Without prejudice to the generality of range of services under sub-section (3), such
services shall include––
(a) provision of acute mental healthcare services such as outpatient and inpatient
services;
(b) provision of half-way homes, sheltered accommodation, supported accommodation as
may be prescribed;
(c) provision for mental health services to support family of person with mental illness or
home based rehabilitation;
(d) hospital and community based rehabilitation establishments and services as may be
prescribed;
(e) provision for child mental health services and old age mental health services.
• Right to community living
• (1) Every person with mental illness shall,––
(a) have a right to live in, be part of and not be segregated from society; and
(b) not continue to remain in a mental health establishment merely because he
does not have a family or is not accepted by his family or is homeless or due to absence
of community based facilities.
• (2) Where it is not possible for a mentally ill person to live with his family or relatives,
or where a mentally ill person has been abandoned by his family or relatives, the
appropriate Government shall provide support as appropriate including legal aid and
to facilitate exercising his right to family home and living in the family home.
• (3) The appropriate Government shall, within a reasonable period, provide for or
support the establishment of less restrictive community based establishments
including half-way homes, group homes and the like for persons who no longer
require treatment in more restrictive mental health establishments such as long stay
mental hospitals.
• Right to protection from cruel, inhuman and degrading
treatment
• (1) Every person with mental illness shall have a right to live with dignity.
• (2) Every person with mental illness shall be protected from cruel, inhuman or degrading treatment
in any mental health establishment and shall have the following rights, namely:—
(a) to live in safe and hygienic environment;
(b) to have adequate sanitary conditions;
(c) to have reasonable facilities for leisure, recreation, education and religious practices;
(d) to privacy;
(e) for proper clothing so as to protect such person from exposure of his body to maintain his
dignity;
(f) to not be forced to undertake work in a mental health establishment and to receive appropriate
remuneration for work when undertaken;
• (g) to have adequate provision for preparing for living in the community;
• (h) to have adequate provision for wholesome food, sanitation, space and access to articles of
personal hygiene, in particular, women’s personal hygiene be adequately addressed by providing
access to items that may be required during menstruation; (i) to not be subject to compulsory
tonsuring (shaving of head hair); (j) to wear own personal clothes if so wished and to not be forced
to wear uniforms provided by the establishment; and (k) to be protected from all forms of physical,
verbal, emotional and sexual abuse.
• Right to equality and non- discrimination
• (1) Every person with mental illness shall be treated as equal to persons with
physical illness in the provision of all healthcare which shall include the following,
namely:–
(a) there shall be no discrimination on any basis including gender, sex, sexual
orientation, religion, culture, caste, social or political beliefs, class or disability;
(b) emergency facilities and emergency services for mental illness shall be of the
same quality and availability as those provided to persons with physical illness;
(c) persons with mental illness shall be entitled to the use of ambulance services in
the same manner, extent and quality as provided to persons with physical illness;
(d) living conditions in health establishments shall be of the same manner, extent
and quality as provided to persons with physical illness; and
(e) any other health services provided to persons with physical illness shall be
provided in same manner, extent and quality to persons with mental illness. (
• (2) A child under the age of three years of a woman receiving care, treatment or
rehabilitation at a mental health establishment shall ordinarily not be separated
from her during her stay in such establishment: Provided that where the treating
Psychiatrist, based on his examination of the woman, and if appropriate, on
information provided by others, is of the opinion that there is risk of harm to the
child from the woman due to her mental illness or it is in the interest and safety of
the child, the child shall be temporarily separated from the woman during her stay
at the mental health establishment: Provided further that the woman shall
continue to have access to the child under such supervision of the staff of the
establishment or her family, as may be appropriate, during the period of
separation.
• (3) The decision to separate the woman from her child shall be reviewed every
fifteen days during the woman's stay in the mental health establishment and
separation shall be terminated as soon as conditions which required the
separation no longer exist: Provided that any separation permitted as per the
assessment of a mental health professional, if it exceeds thirty days at a stretch,
shall be required to be approved by the respective Authority.
• (4) Every insurer shall make provision for medical insurance for treatment of
mental illness on the same basis as is available for treatment of physical illness.
• Right to information
• (1) A person with mental illness and his nominated representative shall have the rights to
the following information, namely:––
(a) the provision of this Act or any other law for the time being in force under which he
has been admitted, if he is being admitted, and the criteria for admission under that
provision;
(b) of his right to make an application to the concerned Board for a review of the
admission;
(c) the nature of the person’s mental illness and the proposed treatment plan which
includes information about treatment proposed and the known side effects of the
proposed treatment;
(d) receive the information in a language and form that such person receiving the
information can understand.
(2) In case complete information cannot be given to the person with mental illness at the
time of the admission or the start of treatment, it shall be the duty of the medical officer or
psychiatrist in-charge of the person’s care to ensure that full information is provided
promptly when the individual is in a position to receive it: Provided that where the
information has not been given to the person with mental illness at the time of the
admission or the start of treatment, the medical officer or psychiatrist in charge of the
person’s care shall give the information to the nominated representative immediately.
• Right to confidentiality.
• (1) A person with mental illness shall have the right to confidentiality in respect of his
mental health, mental healthcare, treatment and physical healthcare.
• (2) All health professionals providing care or treatment to a person with mental illness
shall have a duty to keep all such information confidential which has been obtained
during care or treatment with the following exceptions, namely:––
(a) release of information to the nominated representative to enable him to fulfil his
duties under this Act;
(b) release of information to other mental health professionals and other health
professionals to enable them to provide care and treatment to the person with mental
illness;
(c) release of information if it is necessary to protect any other person from harm or
violence;
(d) only such information that is necessary to protect against the harm identified shall
be released;
(e) release only such information as is necessary to prevent threat to life;
(f) release of information upon an order by concerned Board or the Central Authority
or High Court or Supreme Court or any other statutory authority competent to do so; and
(g) release of information in the interests of public safety and security.
 • Right to access medical records.
• Restriction on release of • (1) All persons with mental illness shall
information in respect of have the right to access their basic
mental illness. medical records as may be prescribed.
• • (2) The mental health professional in
(1) No photograph or any other
charge of such records may withhold
information relating to a person specific information in the medical
with mental illness undergoing records if disclosure would result in,––
treatment at a mental health (a) serious mental harm to the
establishment shall be released person with mental illness; or
to the media without the (b) likelihood of harm to other
consent of the person with persons.
mental illness. (3) When any information in the medical
records is withheld from the person, the
• (2) The right to confidentiality mental health professional shall inform
of person with mental illness the person with mental illness of his
shall also apply to all right to apply to the concerned Board for
information stored in electronic an order to release such information
or digital format in real or
virtual space
• Right to personal contacts and communication
• . (1) A person with mental illness admitted to a mental health
establishment shall have the right to refuse or receive visitors and to
refuse or receive and make telephone or mobile phone calls at reasonable
times subject to the norms of such mental health establishment.
• (2) A person with mental illness admitted in a mental health establishment
may send and receive mail through electronic mode including through e-
mail.
• (3) Where a person with mental illness informs the medical officer or
mental health professional in charge of the mental health establishment
that he does not want to receive mail or email from any named person in
the community, the medical officer or mental health professional in
charge may restrict such communication by the named person with the
person with mental illness.
• (4) Nothing contained in sub-sections (1) to (3) shall apply to visits
from, telephone calls to, and from mail or e-mail to, and from
individuals, specified under clauses (a) to (f) under any
circumstances, namely:––
• (a) any Judge or officer authorised by a competent court;
• (b) members of the concerned Board or the Central Authority or the
State Authority;
• (c) any member of the Parliament or a Member of State Legislature;
• (d) nominated representative, lawyer or legal representative of the
person;
• (e) medical practitioner in charge of the person’s treatment;
• (f) any other person authorised by the appropriate Government
• Right to legal aid • Right to make complaints
• (1) A person with mental illness shall be about deficiencies in provision
entitled to receive free legal services to of services
exercise any of his rights given under
this Act. • (1) Any person with mental illness or his
• (2) It shall be the duty of magistrate, nominated representative, shall have the
police officer, person in charge of such right to complain regarding deficiencies in
custodial institution as may be provision of care, treatment and services
prescribed or medical officer or mental in a mental health establishment to,—
health professional in charge of a (a) the medical officer or mental health
mental health establishment to inform professional in charge of the establishment
the person with mental illness that he is and if not satisfied with the response;
entitled to free legal services under the (b) the concerned Board and if not
satisfied with the response;
Legal Services Authorities Act, 1987 or
other relevant laws or under any order (c) the State Authority.
of the court if so ordered and provide • (2) The provisions for making complaint
the contact details of the availability of in sub-section (1), is without prejudice to
the rights of the person to seek any
services
judicial remedy for violation of his rights
in a mental health establishment or by
any mental health professional either
under this Act or any other law for the
time being in force.
 Critical Insight to IMHA(2017)
• Highlights from MHCA2017
• It ensures that these persons have a right to live life
with dignity by not being discriminated against or • Concordance of India’s Mental
harassed. Healthcare Act 2017 with the World
• This act empowers accessibility (affordable, and of Health Organization’s “Checklist on
good quality) to mental health services for all. mental
• The concept of advance directive, which gives health legislation” (World Health
patients more power to decide certain aspects of Organization, 2005)
their own treatment. • The IMHA addresses 96/175 (55.4%)
• It gives Agency to the person with mental illness in of the WHO-RB standards examined.
its various provitions • When other relevant Indian
• The act also assures free quality treatment for legislation is taken into account,
homeless persons or for those belong to below 118/175 (68.0%) of the standards are
poverty line (BPL), even if they do not possess a BPL addressed in Indian law.
card. • Important areas of low concordance
• The newly introduced decriminalization of suicide is include the rights of families and
definitely a welcome move. carers, competence and
• The bill does not direct any provisions to the factors guardianship, non-protesting
like socioeconomic factors by which mental illness patients and involuntary community
and their situations are being aggravated . treatment
• The mental healthcare bill does not offer much on
prevention and early intervention
 Human Right Violation in Mental health

• A case report:
• Mr. K, a 41 year old unmarried gentleman from a rural village of South India,
belonging to a lower socio-economic status, was premorbidly well-adjusted and
one amongst the few who graduated from his village. He had been suffering from
Paranoid Schizophrenia for the past 21 years. Apparently, about 17 years ago he
was treated in a tertiary care center for his illness but discontinued treatment
within a year due to non-affordability and non-availability of medications as
reported by a family member. His illness worsened following drug default, and as
the patient was difficult to manage, in 1997, family members confined him to a
room at home. He was home-bound in a single room on the terrace and the
room had no proper ventilation or sanitary facilities. Food was given through a
single window whenever the patient made some noise or threw objects
indicating that he was hungry. His personal care was neglected throughout these
years Six years ago, the room in which patient was confined was further reduced
in space by dividing it into two rooms and patient’s room from then on had no
door and only a small window.
 Mental Health Advocacy

• The concept of mental health advocacy has been developed to

promote the human rights of persons with mental disorders
and to reduce stigma and discrimination.
• It consists of various actions aimed at changing the major
structural and attitudinal barriers to achieving positive mental
health outcomes in populations.
• Advocacy in this field began when the families of people with
mental disorders first made their voices heard. People with
mental disorders then added their own contributions.
• Gradually, these people and their families were joined and
supported by a range of organizations, many mental health
workers and their associations, and some governments
• Recently, the concept of advocacy has been broadened to include the needs and
rights of persons with mild mental disorders and the mental health needs and rights
of the general population.
• Advocacy actions • Stakeholders in mental
• Advocacy is considered to be one of health advocacy
the eleven areas for action in any
mental health policy because of the
• Consumers and families
benefits that it produces for people • General health workers and
with mental disorders and their mental health workers
families
• Policy-makers and planners
• > Awareness-raising • Ministries of health
• > Information • General population
• > Education
• > Training
• > Mutual help
• > Counselling
• > Mediating
• > Defending
• > Denouncing
• Importance of mental health advocacy
• The emergence of mental health advocacy movements in several
countries has helped to change society’s perceptions of persons
with mental disorders.
• Consumers have begun to articulate their own visions of the
services they need. They are increasingly able to make informed
decisions about treatment and other matters in their daily lives.
• Consumer and family participation in advocacy organizations may
also have several positive outcomes.
• The advocacy movement has substantially influenced mental
health policy and legislation in some countries and is believed to be
a major force behind the improvement of services in others (World
Health Organization, 2001a ).
 Conclusion
Dispite of having various legislation regarding the rights of the mentally ill
persons , People with mental illness encountering human rights violations in
meeting their basic needs are a reality to be found in every corner of the
globe.(Gostin,2000).Many studies have showed that the human rights of
people with mental illness were not protected and influencing their
reintegration into the community. (Vijaylakshmi, Ramchandra;2014
• Real life factors such as poverty; illiteracy; income inequality;
homelessness; war and displacement; discrimination based on ethnicity,
race, and gender; social exclusion; stigma; and abuse all impact the
mentally ill individual’s ability to access services and realize full
personhood within their communities.
• These factors also play a role in enhancing individual risk for mental
disabilities and so, too, they act to hinder recovery and reintegration
into social and occupational life.
• It is high time to strengthen the legal frame work to protect the rights of
people with mental illness.
• However, legal sanction may not provide adequate protection; hence mental
health professionals, NGOs, professional organizations, and other
stakeholders should unify their efforts in educating and changing community
attitudes towards mental illness and advocating for human rights of people
with mental illness..
• While health care professionals undoubtably have a role to play as
advocates for equality, non-discrimination, and justice, it is persons with
mental disabilities themselves who have the right to exercise agency in their
own lives and who, consequently, should be at the center of advocacy
movements and the setting of the advocacy agenda. In support of this
agenda, health care professionals need to become activists for the social and
economic transformation of society into an environment in which those with
mental disabilities can experience substantive equality.
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