freedom from ill-treatment

Why is freedom from ill-treatment an MDAC goal?

People with psycho-social disabilities and intellectual disabilities suffer a wide range of abuse, exploitation and violence, including

• being kept in cold, dirty, degrading conditions
• being injected with psychiatric treatment against their will  
• forced abortions and sterilisations
• the use of physical restraints such as leather straps, cage beds,  
• the use of unproved and unnecessary or dangerous “treatments” such as showering, detaining someone on the basis of epilepsy 
• sexual abuse in institutions and in community settings  
• denying someone with disabilities the reasonable adjustments they need in (for example) prison
• in sub-Saharan Africa, being chained to a tree or a house in local community or by a traditional healer or in a prayer camp

People with psycho-social disabilities and intellectual disabilities are especially vulnerable to abuse and neglect because they may

• be socially isolated in institutions or in the community
• be detained in an institution which is not regularly monitored by independent bodies
• lack information about accessing services
• be forced to take psychiatric medication without their consent, which may result in severe side effects
• be deprived or restricted of legal capacity
• have a disability which makes it easier to be exploited and for access to justice to be denied.

A major concern for the user and survivor of psychiatry movements is forced psychiatric treatment, psychiatry being the only medical provision where the State allows non life-saving treatment to be imposed on people who have refused such treatment. Patients in psychiatric hospitals and residents in social care institutions are, because of the institutionalization, sometimes subject to verbal, physical and sexual abuse. The use and abuse of physical and chemical restraints and seclusion are often not regulated or monitored. In some State-run institutions people die of neglect.

How is freedom from ill-treatment a human rights issue?

Article 3 of the European Convention on Human Rights sets out an absolute prohibition on torture, inhuman and degrading treatment or punishment. Similarly other human rights treaties reiterate the absolute prohibition. In the UN Convention on the Rights of Persons with Disabilities, Article 17 protects the physical and mental integrity of persons with disabilities on an equal basis with others. Article 15 protects people with disabilities from torture, cruel, inhuman or degrading treatment or punishment, including consent to scientific and medical experimentation, whilst Article 25 provides that healthcare treatments can be given to a person only on the basis of that person’s consent, a point made in a 2008 report of the UN Special Rapporteur on Torture.

The right to be free from sexual, physical and mental abuse is covered by Article 16 which also protects against exploitation and violence. A vital aspect of this human rights goal is that each State has a responsibility to investigate credible allegations of ill-treatment. This goal also includes the issue of deaths in institutions, and the adequacy of investigations after deaths, covered by Article 10 of the UN Convention on the Rights of Persons with Disabilities as well as Articles 2 and 3 of the European Convention on Human Rights. Prevention of torture and other forms of ill-treatment are specified by the Optional Protocol to the UN Convention against Torture (OPCAT), and by Art. 16(3) of the UN Convention on the Rights of Persons with Disabilities which calls for monitoring of facilities and programmes designed to serve people with disabilities.

What MDAC is calling for?

• Consent and refusal to mental health treatment respected
• Regular independent monitoring of services for people with disabilities
• An end to physical and chemical restraints and seclusion
• Investigations into allegations of ill-treatment, and deaths