Human Rights, Mental Health and Changes in the Role of Psychiatry

ABSTRACT SA1-2

DAINIUS PŪRAS

Vilnius University Medical Faculty Psychiatric Clinic, Vilnius, Lithuania
UN Special Rapporteur on the Right to Health

ABSTRACT DESCRIPTION

Psychiatry and human rights have a complicated history of relationships.

Now, when mental health is emerging out of shadows globally as a health and development priority, it is of crucial importance to reach agreement between all major stakeholders on how to invest in mental health promotion and treatment of mental health conditions.

Lessons should be learned from examples of systemic failures when resources have been invested in ineffective mental health systems that rely on legacy of large residential institutions, separated psychiatric hospitals, excessive use of biomedical interventions and wide-spread use of coercion.  For example, in some European countries that joined the EU in 2004-2007, EU structural funds have been used to strengthen the ineffective care systems and thus development of good quality community based services was halted.

Modern psychiatry should address human rights as a priority. Psychiatric profession, as an influential actor in the mental health scene, should reconsider some basic positions with regard to human rights in mental healthcare.

Following issues should be addressed: 

  • power asymmetries in mental health services;
  • excessive use of biomedical model and biomedical interventions;
  • issues related to informed consent, implementation of the Convention on the Rights of Persons with Disabilities and whether arguments based on concepts of dangerousness and medical necessity justify wide-spread use of non-consensual measures in practice of psychiatry.

It is important for leadership of psychiatric profession – nationally, regionally and globally – to openly discuss emerging issues within profession and with other actors and to consider changes in position with regard to critical issues.

The presentation will argue that attempts to preserve the status quo and imbalances, such as power asymmetries, overreliance on biomedical interventions and “exceptions” paving the way to wide-spread use of non-consensual measures, are not contributing to progress in psychiatry and to good image and reputation of the profession.