Human rights of people with mental disabilities

This thesis explores the human rights of people with mental disabilities in regional Queensland, Australia, within the context of contemporary human rights frameworks adopted by the United Nations and the World Health Organization. The study was informed by a scoping literature review to synthesise the current knowledge in this field and identify gaps. It is a qualitative study using a ‘stellar approach’ characterised by superimposed triangulation of data sources and data-gathering methods. This involved semi-structured interviews with persons with mental disabilities and carers, a focus group with stakeholders and consultations with legal and psychiatric experts. The data were analysed iteratively, informed by post-modernist and critical realist frameworks. Abductive analysis – a combination of deductive and inductive analyses – was conducted. In the interest of reflexivity, a chapter on the positioning of the candidate as a situated researcher was included. This study found widespread violations of the human rights of people with mental disabilities. Involuntary/coercive psychiatric treatment; inadequate access to healthcare; and stigma and discrimination were found to be the most common violations of rights. While most participants, including service-users, agreed with the need to retain involuntary treatment provisions as the last resort, many participants highlighted the excessively restrictive ways in which involuntary treatment was enforced, violating their dignity. Poor access to healthcare, especially in rural and remote areas, was highlighted. Social exclusion through stigma, ‘the lonely road’, was the most distressing violation of rights. The study concluded that citizenship approaches, coupled with the capabilities approach to social justice may provide a philosophical basis for promotion of human rights of people with mental disabilities, which can then be practically implemented by addressing the social determinants of health and adopting the recovery paradigm in mental health. Specific strategies include: mental health promotion and prevention and access to early intervention; policy/legislative mechanisms to minimise coercion; the provision of voluntary, community-based, recovery-oriented services; and the social movement approach to promote the right to social inclusion and freedom from stigma/discrimination. Promotion of economic, social and cultural rights of people with mental disabilities would pave the way for protection of their civil and political rights