The Convention on the Rights of Persons with Disabilities (CRPD) is the first international human rights treaty of the 21st century. It is historic for bringing mental health issues more forcefully than ever before into the fold of international human rights law. The book looks at how the CRPD and its articulation of autonomy, human dignity and solidarity provide a conceptual and practical alternative to existing mental health legislation. It challenges long-held views on mental health legislation and is a timely development given major issues facing mental health systems in Western high-income countries, on which the book concentrates.
The book is ambitious in appealing to a very wide audience who have an interest in mental health, disability and human rights, including those ‘engaged in the daily puzzles of mental health’. It is designed so that readers can skip to certain sections to suit their knowledge needs.
The book comprises seven chapters and a lengthy conclusion and is divided into two parts. Part 1 considers what human rights mean for mental health law. The composition of the CRPD is explained, as are the main CRPD articles related to mental health legislation. The hugely significant implications of the CRPD are described, including the potential abolition of mental health legislation in its entirety, abolition of laws allowing community treatment orders and the abolition of mental health legislation allowing forced treatment, as these violate various CRPD articles. This part may have been helped by having the full list of CRPD articles in an additional appendix and possibly a review of further accessible information sources for the CRPD.
Part 2 considers the CRPD and mental health law acting together or as a new paradigm. This part is where professionals will find useful discourse on how the CRPD influences mental health legislation. Chapter 7 is probably the most useful chapter for professionals in that it provides a very balanced review, addressing major concerns and the ‘threat’ to mental health legislation that it is perceived as discriminatory. This chapter reflects on real-life dilemmas and the resource practicalities needed to help support CRPD implementation. An important section considers the perennial balancing act of individual autonomy with the ‘collectivist, paternalistic agendas’ regarding risk management – with mental health legislation having a strong risk-aversion focus as opposed to the relatively low priority given to risk under the CRPD. Under the CRPD, ‘best interests’ determinations would be replaced by ‘best interpretation of will and preferences’, which is examined in depth.
Despite the fact that many unresolved issues and ambiguities remain, and no government has yet fully implemented the CRPD by entirely abolishing mental health legislation, the book finds no ‘plausible reasons’ as to why domestic law, policy and practice could not generally be reshaped in accordance with the CRPD. Although it clearly advocates the innovation of the CRPD approach, it does acknowledge the enormity of the epoch-making change needed to implement this and makes a series of recommendations in this regard.
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