Barriers to justice are barriers to equality
When Non-Governmental Organizations address the topic of equality, the criticism is usually the same – that people are not born equal, and thus asking for equality is naive and unfeasible. However, it all depends on what you perceive as fairness, and where you stand on the role of society. It is equality of chances that Mental Health Europe advocates, and the removal of barriers that sit between people with mental health problems and their ability to live their life fully, happily, and independently.
Unfortunately, on the World Day of Social Justice, Mental Health Europe is concerned that barriers are lifted, instead of torn down, and that the response to the financial crisis is further burdening people with mental health problems.
While conducting research for its Mapping Exclusion report, Mental Health Europe found that sixteen European countries have, or are currently developing mental health strategies that identify deinstitutionalization, or the strengthening of community based-care, as an objective. For example, Belgium aims to reduce the number of psychiatric beds by 10%, while Finland foresees a 30% reduction in psychiatric hospital beds by 2015. These are all very encouraging statistics. However, the absence of long-term residential institutions does not always guarantee that people with mental health problems will be given autonomy over their own lives, or will live free from forced treatment or constraint.
Even in countries like the United Kingdom, which has started implementing deinstitutionalization decades ago, people with mental health problems can still be detained in psychiatric hospitals against their will, as 16,647 actually were in the period of 2010 – 2011. Moreover, Community Treatment Orders (CTOs) are increasingly used, where patients can, at their clinician’s discretion, be returned to hospital for compulsory treatment if they stop taking their medication and/or disengage with services. In the period between 2011 and 2012, an estimated 4220 people in England were subject to a CTO. Similar tendencies have been noticed in France, where psychiatric care without consent may now be dispensed outside of the hospital based on a new law that entered into force in 2011. The law allows psychiatrists to prescribe anti-psychotic drugs, for example, without the consent of the patient, on an outpatient basis.
Consequently, a growing number of people detained under the Mental Health Act in the UK are being denied access to lawyers, which could help overturn their involuntary placement, because of a quota system limiting the use of legal aid. Also, while people detained under the Mental Health Act, or subject to a CTO, have a legal right to an independent mental health advocate, the Care Quality Commission found out that patients were informed of this right only in 65% of wards. Also, research shows that CTOs target people following certain societal patterns - people from the ethnic minority groups make up 15% of the CTO population, compared with 2.9% of the general population.
While Mental Health Europe is still strongly against any form of involuntary placement, we realize that complete deinstitutionalization takes years. In the meantime, people with mental health problems must have access to legal services, as the European Convention on Human Rights and Article 13 of the United Nations Convention for the Rights of Persons with Disabilities stipulate. More than 12% of all involuntary placement orders are successfully appealed, and this should not be dependent on income, especially as some people with mental health problems have difficulty managing their finances, and one in four people with mental health problems are in debt.
No real change can take place in the lives of people with mental health problems until they are allowed to live independently, free from the threat of forced medication or hospitalization. On the World Day of Social Justice, Mental Health Europe calls on EU Member States to implement appropriate actions that ensure freedom and equality for people with mental health problems. Not doing so would simply be unjust.
For more information, please contact Silvana Enculescu, MHE Information and Communications Manager, at email@example.com