Segment 5: Articles 19 and 25

This segment is meant to consider the CRPD framework in relation to changing practices of support and services provided to people through the mental health system.  The nature of services in the current system is managerial, top-down, paternalistic and controlling.  One strand of the problem is the medical model of psychiatry, which pathologizes psychic pain and inner conflict (and divergence, and much more).  Another is the legalized coercion which, we have already seen, is prohibited by Articles 12, 14 and 15.

What would true support look like?  Can Article 19, on living independently and being included in the community, offer a paradigm for a new approaches to services for people with psychosocial disabilities and/or people experiencing any kind of distress or trauma?

What about the words we use, like psychosocial disability, mental health condition, madness, distress, crisis, etc.?  How do the different terms reflect and produce different ways of thinking about what is going on, and different ways of acting?

Does Article 19 overlap with Article 12.3 on the obligation to provide support in exercising legal capacity, which respects the person’s autonomy, will and preferences?  Does it matter whether we think about supports desired by people with psychosocial disabilities under Article 19 or Article 12?

 

*Essential reading

UN materials:

*CRPD Article 19 and Article 25

*CRPD General Comment No. 1, paragraphs 44-46 & 52

*CRPD draft General Comment No. 5 (on Article 19) – the draft can be downloaded on this page; note that the Committee welcomes comments and feedback as indicated

Special Rapporteur on the Rights of Persons with Disabilities, Report on access to rights-based support for persons with disabilities and/or Easy-to-Read version

OHCHR Report on right to live independently & be included in community

 

 

Free and informed consent in health/mental health as human right vs gatekeeping:

Minkowitz, Free and informed consent and the right to refuse treatment (ppt/pdf version: MinkowitzConsent) and video

 

Initiatives and practices related to support:

*CHOOSE ANY THREE of the following:

Disability Integration Act (introduced in US Congress) – summary of provisions (note that LTSS means long term support services) OR bill text sections 3 and 4

Report from meeting on model law of inclusion

Intentional Peer Support, What is IPS? (feel free to explore rest of site)

PO-Skåne, personal ombudsperson (Article 12, Article 19 or both?)

Report on Transforming Communities for Inclusion-Asia (good background information on issues, using Article 19 for rights of people with psychosocial disabilities – long paper)

Sarah Knutson, Peerly Human: Why We Need a New Recovery

 

Resources:

European Network on Independent Living Manual

Indicators (CHRUSP/Absolute Prohibition campaign), see under Articles 19 and 25

 

Compare:

Common European Guidelines on Transition from Institutional to Community-Based Care (notice how and where it diverges from CRPD standards)

 

Recording of lecture

Power point segment 5 presentation and pdf segment 5 presentation

 

Assignment:

1-2 page papers

Explore CRPD Committee’s Concluding Observations on Article 19 for at least 3 countries.  (They are short; search in the docs you choose for the paragraphs dealing with Article 19.)  Are they relevant to people with psychosocial disabilities?  How so, or how not?  Do you have suggestions for improvement?

OR

Consider the initiatives and practices you have read about (from choices above).  What do you think are the most important elements to include in law and/or policy reform on supports for people with psychosocial disabilities?

OR

Based on your own experiential knowledge, what do you think is, or should be, the relationship between mental health services and support for persons with psychosocial disabilities under Article 19?  Consider the approach taken in the CHRUSP/Absolute Prohibition Indicators.  Do you agree or disagree, please discuss.

 

(c) Tina Minkowitz 2017