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On Human Rights Day, some global challenges, recognition for champions, and calls for safer mental health systems

Introduction by Croakey:

Rampant poverty, pervasive inequalities and structural discrimination are human rights violations and among the greatest global challenges of our time.

Addressing them effectively requires measures grounded in human rights, renewed political commitment and participation of all, especially those most affected.

We need a new social contract which more fairly shares power, resources and opportunities and sets the foundations of a sustainable human rights-based economy.”

These are among the calls to action from the United Nations in marking today (10 December) as Human Rights Day, commemorating that day in 1948 when the UN General Assembly adopted the Universal Declaration of Human Rights (UDHR) – the most translated document in the world.

This year, the UN is calling for an end to vaccine inequality, a human rights-based economy that supports better, fairer and more sustainable societies for present and future generations, and for urgent action to “respect, protect and fulfil” the human right to a clean, healthy and sustainable environment.

The UN says human rights have the power to tackle the root causes of conflict and crisis, by addressing grievances, eliminating inequalities and exclusion, and allowing people to participate in decision-making that affect their lives.

“Societies that protect and promote human rights for everyone are more resilient societies, better equipped through human rights to weather unexpected crises such as pandemics and the impacts of the climate crisis,” it says.

“Equality and non-discrimination are key to prevention: all human rights for all ensure everyone has access to the preventive benefits of human rights but, when certain people or groups are excluded or face discrimination, the inequality will drive the cycle of conflict and crisis.”

Human Rights Day is also an opportunity for recognising those whose work across many spheres contributes to greater equity; in Australia, the Human Rights Medal has been awarded to academic, author, filmmaker and broadcaster Distinguished Professor Larissa Behrendt – Director of Research at the Jumbunna Indigenous House of Learning at the University of Technology Sydney.

Read more about others who’ve been recognised here.According to the authors below, Human Rights Day is also a day for considering how to address violations of human rights for those experiencing traumatising mental health systems – including through structural changes to promote the influence of people with lived experience as experts.

Simon Katterl is a human rights and regulation consultant, with his own lived experience of mental health issues, and Tim Heffernan is a lived experience peer worker and advocate.


Simon Katterl and Tim Heffernan write:

Human rights week is important for people who access the mental health system. Each December is a time to focus on human rights. Mostly, in Australia we look outwards to focus on human rights violations.

Increasingly though, we’re beginning to look at ourselves and the way we treat people in our own country.

How can we ignore the harms that we and our governments cause Aboriginal and Torres Strait Islander people, refugees, women, and the elderly to name just a few?

There is also a growing awareness of the need to focus on the human rights violations experienced by those who live with the stigmatising labels applied to people who have been diagnosed with ‘mental illness’.

Twelve years ago, in 2009, the Australian Government ratified the Convention on the Rights of Disability (CRPD). It is an international human rights treaty that requires us to radically transform our understanding and response to disability and to mental and emotional distress.

Part of this radical transformation should have been the elimination of all forms of forced treatment (see CRPD General Comment 1), except that the Australian Government made an interpretive declaration stating that it believes forced treatment complies with the CRPD.

Unfortunately, at present, all Australian state and territory laws continue to permit forced treatment.

What do these laws and mental health systems look like in practice? People with lived experience of mental health issues of course have diverse experiences, but overwhelmingly they describe the use of force as harmful and traumatising.

The Royal Commission into Victoria’s Mental Health System found evidence of this time and again. In a depressingly common account, a woman providing evidence about her experiences in an inpatient unit, explains:

I was too scared to raise it with them. Talking to the other patients, I was told that ‘if you say no, you will just stay longer’. So, I took the medication that left me sedated and drooling.”

Others described being pepper sprayed by police and restrained in a bed without treatment on their eyes. These are experiences of control rather than care. They are human rights violations that are made legal by mental health laws.

This ongoing application of control erodes trust in systems and one’s equal citizenship in an ostensibly liberal and egalitarian community.

For example, someone described their traumatic relationship with the mental health system:

[T]he system impresses itself upon you and imprisons you. You can’t think from the medication. People stop calling your phone. Relationships are gone. Your life changes. Your person is dead.

But you are meant to go on pretending that everything is normal. And you never have any choice about the matter. It’s an invisible and symbolic prison.

Victoria is not alone in identifying the issue. Danius Puras, the former UN Special Rapporteur on physical and mental health reported that this was in part the result of:

…power imbalances that lead to biased use of evidence, a lack of investment in rights-based policies and services, and overreliance on coercive, punitive and overmedicalized measures.”

Radical change

It is important to note that while these systems permit the use of force, they do purport to provide basic rights and minimum standards. Unfortunately, these are breached with such regularity as to be appear illusory. Mental health systems must heal trauma, not cause, or compound it.

To do that radical change is needed. On one level this change is structural.

The National Mental Health Commission has been tasked with developing a new National Strategy to reduce and eliminate stigma and discrimination towards people who experience mental ill-health or distress and those who support them. We hope that this process will tackle human rights issues and give them national attention.

At another level, radical change requires building alternatives. Alternatives that adopt an understanding of distress as reflective of complex social and psychological factors.

The thing is, people with lived experience of mental and emotional distress have, for decades, offered these alternatives (often unfunded!).

The Lived Experience (Peer) workforce is an alternative to ‘illness’ based interventions. The Lived experience work force grew out of the Mental Health Consumer Movement and so has its values and principles embedded in human rights and social justice.

It is an approach whereby a person uses their personal experience of mental health challenges, service use or periods of healing and/or recovery to support someone who may be going through similar experiences. While other disciplines provide a focus on assessment and intervention, lived experience (peer) work focuses on mutuality, reciprocity, and meaning-making.

It is a “professional” discipline in its own right, with the Commission last week releasing the National Lived Experience (Peer) Workforce Development Guidelines.

Such an approach supports people’s mental health and wellbeing, but it is also crucial in addressing stigma and human rights violations.

Acknowledging people with lived experience as experts and placing them in expert-roles is an action that will reduce stigma and discrimination, and promote human rights.

Simon Katterl (he/him) is human rights and regulation consultant, with his own lived experience of mental health issues

Tim Heffernan (he/him) is a lived experience peer worker and advocate.


See Croakey’s archive of stories on human rights and health.

 

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WHO
health
Healthcare and health reform
abortion
adverse events
Aged care
Allied healthcare
Australian Medical Association
cancer
cardiovascular disease
child health
Choosing Wisely
chronic diseases
co-payments
Cochrane Collaboration
complementary medicines
conflicts of interest
death and dying
diabetes
digital technology
disabilities
e-health
emergency departments and care
Equally Well
euthanasia
evidence-based issues
general practice
genetics
health & medical marketing
health and medical education
health and medical research
Health Care Homes
health ethics
health financing and costs
Health reform
health regulation
Health workforce
HIV/AIDS
hospitals
HRT
infectious diseases
influenza
international medical graduates
journal articles
LGBTIQ
medical marijuana
Medicare Locals
men's health
Mental health
MyHospitals website
National Commission of Audit 2014
National Health Performance Authority
naturopathy
NDIS
NHMRC
non communicable diseases
Nursing and midwifery
oral health
organ transplants
out of pocket costs
pain
palliative care
paramedics
pathology
Pharmaceutical Benefits Scheme
pharmaceutical industry
pharmacy
Pregnancy and childbirth
Primary Health Networks
Primary healthcare
private health insurance
Rural and remote health
Safety and quality of healthcare
screening
sexual health
Social media and healthcare
suicide
surgery
swine flu
telehealth
tests
TGA
trauma
women's health
youth health
Indigenous health
#CTG10
#NTRC
Acknowledgement
cultural safety
Indigenous education
Lowitja Institute