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1.
J Law Med ; 31(2): 421-437, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38963254

RESUMEN

Victoria has new legislation, the Mental Health and Wellbeing Act 2022 (Vic) (MHWA) to govern the care and treatment of people with mental illness that came into effect on 1 September 2023. It takes a human rights approach with a focus on person-centred care. The definition of mental illness encompasses conditions such as dementia even though it is rarely used to manage such conditions. How would the management of dementia and associated conditions change if these conditions were managed under the MHWA? This article uses dementia to examine the differences between the new MHWA, the Medical Treatment Planning and Decisions Act 2016 (Vic) and the Guardianship and Administration Act 2019 (Vic) and how the human rights approach taken by the MHWA might inform future directions in managing dementia.


Asunto(s)
Derechos Humanos , Humanos , Derechos Humanos/legislación & jurisprudencia , Demencia , Victoria , Trastornos Neurocognitivos , Trastornos Mentales , Salud Mental
2.
Torture ; 34(1): 150-152, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38975926

RESUMEN

BACKGROUND: Conventions adopted by the United Nations and Council of Europe pay special importance to the treatment of prisoners with mental health problems. Their treatment is close-ly related to respect for human dignity, and the prohibition of torture, cruel and degrading treatment or punishment. The Eu-ropean Court of Human Rights, in many cases, has ruled that the detention of a mentally-ill person can raise issues under Ar-ticle 3 of the European Convention on Human Rights and that the lack of adequate medical care can result in treatment in con-travention of this article. The Republic of Kosovo is not a mem-ber of the United Nations and Council of Europe. However, it has incorporated in its Constitution a number of Conven-tions adopted by the United Nations and Council of Europe. Also, Kosovo has adopted a legal framework which prohibits torture, cruel and degrading treatment or punishment in ac-cordance with the international human rights standards. The Constitution also provides that human rights and fundamen-tal freedoms guaranteed by the Constitution shall be interpret-ed in accordance with the case law of the European Court of Human Rights. METHODS: Review of Ombudsperson's, Committee for the Prevention of Torture, Prison Health Department of Kosovo Ministry of Health reports, as well as reports of the NGOs in Kosovo.


Asunto(s)
Prisioneros , Tortura , Humanos , Kosovo , Prisioneros/psicología , Tortura/legislación & jurisprudencia , Instalaciones Correccionales , Trastornos Mentales/terapia , Derechos Humanos/legislación & jurisprudencia , Masculino , Enfermos Mentales/legislación & jurisprudencia
3.
S Afr J Psychiatr ; 30: 2233, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38841714

RESUMEN

Background: Psychiatric nurses play an important role in advocating for mental health care users such as advocating for the care, treatment and rehabilitation of mental health care users (MHCUs). Psychiatric nurses face various challenges while advocating for the human rights of MHCUs, particularly those unable to protect their rights because of the severity of their mental health conditions. Aim: This study aimed to explore and describe psychiatric nurses' lived experiences in advocating for the human rights of MHCUs in the Gauteng province. Setting: The study was conducted within the primary healthcare (PHC) setting's mental health services, Sedibeng District, Gauteng province. Methods: The study employed a qualitative, exploratory, descriptive and contextual research design. Three phenomenological focus group interviews were conducted, and audio recorded to collect data. Data were analysed using Tesch's method. Results: Three themes emerged: (1) advocating for human rights was a strong push and an exhausting plea for psychiatric nurses in their attempts to voice and protect MHCUs' rights; (2) MHCUs and mental health services were discriminated against and excluded by various stakeholders; mental health awareness should be raised and (3) training needs to be conducted as a matter of urgency in order to destigmatise mental illness from government to societal level. Conclusion: Psychiatric nurses experienced feelings of disempowerment, frustration and helplessness in advocating for MHCUs' human rights. Contribution: The study's findings will contribute to the body of knowledge in clinical psychiatric mental health practice on advocating for the human rights of MHCUs.

4.
Int J Law Psychiatry ; 95: 102004, 2024 Jun 28.
Artículo en Inglés | MEDLINE | ID: mdl-38943689

RESUMEN

This article critically examines the proposed reforms to Irish mental health law the Mental Health Act 2001 (2001 Act). The article will provide background to the 2001 Act and the lengthy law reform process, which has resulted in the publication of the Heads of Bill that propose significant amendments. The article assesses the suggested reforms, considering Ireland's 2018 ratification of the UN Convention on the Rights of Persons with Disabilities (CRPD), which provides important context to the law reform process. The 2001 Act is the primary piece of legislation regulating mental health services and safeguarding the rights of persons subject to the legislation in Ireland. While passed in 2001, the legislation did not come into effect until 2006. The 2001 Act was seen as bringing Irish mental health law into compliance with international human rights law, in particular the European Convention on Human Rights (ECHR). However, Ireland's ratification of the CRPD has necessitated closer scrutiny of the legislation. This review has culminated in the publication of a Heads of Bill in July 2021 and pre-legislative scrutiny by the responsible parliamentary committee in 2022. The long title of the Heads of Bill explicitly states its goal of safeguarding individual autonomy and underscores its commitment to upholding and advancing the rights of people subject to the legislation. The analysis of the Heads of Bill addresses several key areas. These areas include a background to the long process of review, new guiding principles, the category of persons under the mental health legislation, mental health tribunals, consent to treatment, advance healthcare directives, provisions relating to children and young people, and independent advocacy. Based on this analysis of the Heads of Bill, recommendations are suggested which would strengthen respect for the human rights of persons subject to the legislation.

5.
Health Hum Rights ; 26(1): 101-114, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38933228

RESUMEN

Protecting the rights of people with psychosocial conditions is an important and controversial global aim, particularly in light of multiple calls for reduced coercion catalyzed by General Comment 1 of the United Nations Committee on the Rights of Persons with Disabilities, which stipulates the replacement of substituted care with supported care. Responding to this and other global calls for reduced coercion is complex globally but can entail particular challenges in developing countries, where resource shortages and environmental barriers are sometimes a significant factor in how people with mental conditions experience involuntary care and encounter limitations to their autonomy. To better understand these complexities, our study explored experiences of involuntary care among people with psychosocial conditions in South Africa. Participants described varying degrees of coercion within involuntary care and found that different approaches from professionals when they were in crisis significantly impacted their illness experience, including their ability to make decisions and feel dignified. Participants' reports include variable feelings and embodied experiences of coercion in different forms and degrees, ambivalence about compliance and resistance while being treated against their will, and gray areas between conventional separations of autonomy and paternalism. On the whole, our analysis troubles binaries about the use or disuse of involuntary care and illustrates the complexity of participants' experiences and views of coercive intervention, which could hold multiple possibilities for both care and autonomy.


Asunto(s)
Coerción , Humanos , Sudáfrica , Masculino , Femenino , Autonomía Personal , Trastornos Mentales/terapia , Derechos Humanos , Adulto , Persona de Mediana Edad
7.
Georgian Med News ; (348): 154-160, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38807410

RESUMEN

There is no health without mental health. The rich links between mind, body and the environment have been well-documented for decades. As the third decade of the millennium begins, nowhere in the world has achieved parity between mental and physical health and this remains a significant human development challenge. An important message within that collective failure is that without addressing human rights seriously, any investment in mental health will not be effective. Attacks on universal human rights principles threaten the physical, political, social, and economic environment, and actively undermine the struggle for positive mental health and well-being. Mental health systems worldwide are dominated by a reductionist biomedical model that uses medicalization to justify coercion as a systemic practice and qualifies the diverse human responses to harmful underlying and social determinants (such as inequalities, discrimination, and violence) as "disorders" that need treatment. In such a context, the main principles of the Convention on the Rights of Persons with Disabilities are actively undermined and neglected. This approach ignores evidence that effective investments should target populations, relationships, and other determinants, rather than individuals and their brains. How that dominance is overcome requires transformative human rights action. However, action that focuses only on strengthening failing mental health-care systems and institutions is not compliant with the right to health. The locus of the action must be recalibrated to strengthen communities and expand evidence-based practice that reflects a diversity of experiences. Such community-led recalibration enables the necessary social integration and connection required to promote mental health and well-being more effectively and humanely.


Asunto(s)
Derechos Humanos , Trastornos Mentales , Humanos , Derechos Humanos/legislación & jurisprudencia , Trastornos Mentales/psicología , Enfermos Mentales/legislación & jurisprudencia
10.
Rev. esp. salud pública ; 98: e202404031, Abr. 2024.
Artículo en Español | IBECS | ID: ibc-VR-20

RESUMEN

Aunque el derecho al goce del más alto nivel de salud mental y física que se pueda lograr es un derecho humano universal, no ha sido hasta etapas muy recientes que la salud mental ha empezado a cobrar la relevancia que merece. La atención a la salud materno-infantil ejemplifica las limitaciones de la Sanidad española para ofrecer una atención integral que incluya la dimensión de la salud mental. Durante años, el objetivo principal ha sido combatir la mortalidad materna prevenible, prácticamente erradicada en nuestro país gracias a sus prestaciones sanitarias. Sin embargo, el disfrute de la salud no puede limitarse a lograr la supervivencia de las madres y de sus bebés, y una buena salud materna implica, necesariamente, una buena salud mental perinatal.(AU)


Asunto(s)
Humanos , Masculino , Salud Pública , Salud Mental , Atención Perinatal , Salud Materno-Infantil , Derechos Humanos , España
11.
Health Aff (Millwood) ; 43(4): 470-476, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38560799

RESUMEN

Perinatal mental illness is a leading cause of death during pregnancy and the first postpartum year in the United States. Although better acute care services for mental health conditions are desperately needed, urgent services alone cannot create the conditions to thrive. Cultivating well-being requires a sustained commitment to reproductive justice, "the human right to maintain personal bodily autonomy, have children, not have children, and parent the children we have in safe and sustainable communities." To support reproductive justice for pregnant and birthing people, the Rippel Foundation's Vital Conditions for Health and Well-Being framework offers a holistic approach comprising seven domains: a thriving natural world; basic needs for health and safety; humane housing; meaningful work and wealth; lifelong learning; reliable transportation; and, central to all of these, belonging and civic muscle. Here we review the evidence for each of the vital conditions as key drivers of perinatal mental health, and we outline how this public health approach can advance well-being across generations.


Asunto(s)
Trastornos Mentales , Justicia Social , Embarazo , Femenino , Niño , Humanos , Estados Unidos , Derechos Humanos , Salud Mental , Autonomía Personal
12.
PLoS One ; 19(4): e0300320, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38573997

RESUMEN

This study investigated the structural relationships among parental respect for children's decision-making, respect for human rights, and self-esteem, and their impact on depression in early adolescents. The study utilized data from 2,747 middle school students who participated in the 2020 Survey on the Current Status of Korean Children's and Youth's Rights conducted by the National Youth Policy Institute. The data were analyzed using a structural equation model based on partial least squares with SmartPLS 3.0. The analysis revealed that both parental respect for children's decision-making and respect for human rights perceived by middle school students had a significant positive impact on self-esteem and a significant negative impact on depression. Furthermore, self-esteem was found to have a significant negative effect on depression. Importantly, self-esteem also played a significant mediating role in the relationship between parental respect for children's decision-making and depression, as well as the relationship between respect for human rights and depression. Therefore, in order to manage depression, it is necessary to develop strategies that encourage parental respect for children's decision-making, promote respect for human rights, and foster self-esteem in early adolescents.


Asunto(s)
Depresión , Padres , Niño , Humanos , Adolescente , Autoimagen , Encuestas y Cuestionarios , Derechos Humanos
13.
Lancet Planet Health ; 8(4): e242-e255, 2024 04.
Artículo en Inglés | MEDLINE | ID: mdl-38580426

RESUMEN

Globally, more than 1 billion people with disabilities are disproportionately and differentially at risk from the climate crisis. Yet there is a notable absence of climate policy, programming, and research at the intersection of disability and climate change. Advancing climate justice urgently requires accelerated disability-inclusive climate action. We present pivotal research recommendations and guidance to advance disability-inclusive climate research and responses identified by a global interdisciplinary group of experts in disability, climate change, sustainable development, public health, environmental justice, humanitarianism, gender, Indigeneity, mental health, law, and planetary health. Climate-resilient development is a framework for enabling universal sustainable development. Advancing inclusive climate-resilient development requires a disability human rights approach that deepens understanding of how societal choices and actions-characterised by meaningful participation, inclusion, knowledge diversity in decision making, and co-design by and with people with disabilities and their representative organisations-build collective climate resilience benefiting disability communities and society at large while advancing planetary health.


Asunto(s)
Personas con Discapacidad , Resiliencia Psicológica , Humanos , Derechos Humanos , Salud Mental , Cambio Climático
14.
Health Policy Plan ; 39(5): 499-508, 2024 May 15.
Artículo en Inglés | MEDLINE | ID: mdl-38590053

RESUMEN

This qualitative study maps the process of drafting and consulting on Nepal's mental health legislation from 2006 to 2017. A total of 14 people were interviewed and interviews were analysed thematically. These themes were subsequently interpreted in light of Shiffman and Smith's policy analysis framework, as the process was found to be at the agenda-setting stage. Two groups of actors were identified with different views on appropriate policy content and how the policy process should be conducted. The first group included psychiatrists who initiated and controlled the drafting process and who did not consider people with psychosocial disabilities to be equal partners. The psychiatrists viewed forced detention and treatment as upholding people's right to health and lobbied the Ministry of Health and Population (MoHP) to pass the draft acts to parliament. The second included the rights-based civil society actors and lawyers who saw the right to equality before the law as of utmost priority, opposed forced detention and treatment, and actively blocked the draft acts at the MoHP. There is no clear legal definition of mental health and illness in Nepal, legal and mental capacity are not differentiated, and people with mental and behavioural conditions are assumed to lack capacity. The analysis indicates that there were few favourable conditions to support the progression of this policy into law. It is unclear whether the drafters or blockers will prevail in the future, but we predict that professionals will continue to have more input into content than service users due to national policy dynamics.


Asunto(s)
Política de Salud , Salud Mental , Investigación Cualitativa , Nepal , Humanos , Derecho a la Salud , Trastornos Mentales/terapia , Formulación de Políticas , Entrevistas como Asunto , Servicios de Salud Mental , Derechos Humanos
15.
Eur J Health Law ; 31(3): 312-335, 2024 Apr 22.
Artículo en Inglés | MEDLINE | ID: mdl-38653475

RESUMEN

Mental health legislation is a cornerstone to ensure that individuals with severe mental illness access proper care and treatment. Each country establishes their own legislation. We aimed to compare the Portuguese and Irish Mental Health Acts (MHAs). We reviewed the respective MHA and the literature. While the definition of mental disorder is similar in general, who, where, when and how one can be detained differ. Judges decide on detentions in Portugal, while consultant psychiatrists may do so in Ireland. Community-based compulsory treatment is possible and used in Portugal while it is not possible in Ireland. Pros and cons of each approach are discussed with a reflection on the protection of human rights. Further theoretical and empirical studies comparing systems in different jurisdictions would be helpful to deepen our understanding of the legislation and guide on how to better serve individuals with severe mental illness.


Asunto(s)
Internamiento Obligatorio del Enfermo Mental , Trastornos Mentales , Humanos , Portugal , Irlanda , Internamiento Obligatorio del Enfermo Mental/legislación & jurisprudencia , Trastornos Mentales/terapia , Salud Mental/legislación & jurisprudencia , Derechos Humanos/legislación & jurisprudencia , Servicios de Salud Mental/legislación & jurisprudencia
16.
JMIR Ment Health ; 11: e53096, 2024 Mar 27.
Artículo en Inglés | MEDLINE | ID: mdl-38619212

RESUMEN

Background: In West Africa, healers greatly outnumber trained mental health professionals. People with serious mental illness (SMI) are often seen by healers in "prayer camps" where they may also experience human rights abuses. We developed "M&M," an 8-week-long dual-pronged intervention involving (1) a smartphone-delivered toolkit designed to expose healers to brief psychosocial interventions and encourage them to preserve human rights (M-Healer app), and (2) a visiting nurse who provides medications to their patients (Mobile Nurse). Objective: We examined the feasibility, acceptability, safety, and preliminary effectiveness of the M&M intervention in real-world prayer camp settings. Methods: We conducted a single-arm field trial of M&M with people with SMI and healers at a prayer camp in Ghana. Healers were provided smartphones with M-Healer installed and were trained by practice facilitators to use the digital toolkit. In parallel, a study nurse visited their prayer camp to administer medications to their patients. Clinical assessors administered study measures to participants with SMI at pretreatment (baseline), midtreatment (4 weeks) and post treatment (8 weeks). Results: Seventeen participants were enrolled and most (n=15, 88.3%) were retained. Participants had an average age of 44.3 (SD 13.9) years and 59% (n=10) of them were male. Fourteen (82%) participants had a diagnosis of schizophrenia and 2 (18%) were diagnosed with bipolar disorder. Four healers were trained to use M-Healer. On average, they self-initiated app use 31.9 (SD 28.9) times per week. Healers watched an average of 19.1 (SD 21.2) videos, responded to 1.5 (SD 2.4) prompts, and used the app for 5.3 (SD 2.7) days weekly. Pre-post analyses revealed a significant and clinically meaningful reduction in psychiatric symptom severity (Brief Psychiatric Rating Scale score range 52.3 to 30.9; Brief Symptom Inventory score range 76.4 to 27.9), psychological distress (Talbieh Brief Distress Inventory score range 37.7 to 16.9), shame (Other as Shamer Scale score range 41.9 to 28.5), and stigma (Brief Internalized Stigma of Mental Illness Scale score range 11.8 to 10.3). We recorded a significant reduction in days chained (1.6 to 0.5) and a promising trend for reduction in the days of forced fasting (2.6 to 0.0, P=.06). We did not identify significant pre-post changes in patient-reported working alliance with healers (Working Alliance Inventory), depressive symptom severity (Patient Health Questionnaire-9), quality of life (Lehman Quality of Life Interview for the Mentally Ill), beliefs about medication (Beliefs about Medications Questionnaire-General Harm subscale), or other human rights abuses. No major side effects, health and safety violations, or serious adverse events occurred over the course of the trial. Conclusions: The M&M intervention proved to be feasible, acceptable, safe, and clinically promising. Preliminary findings suggest that the M-Healer toolkit may have shifted healers' behaviors at the prayer camp so that they commit fewer human rights abuses.


Asunto(s)
Calidad de Vida , Trastornos Relacionados con Sustancias , Humanos , Masculino , Adulto , Femenino , Ghana , Derechos Humanos , Violaciones de los Derechos Humanos , Evaluación de Resultado en la Atención de Salud
17.
Int J Law Psychiatry ; 94: 101991, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38663171

RESUMEN

Scotland's mental health and capacity legislation and its implementation is underpinned by European Convention on Human Rights (ECHR) informed principles, and such legislation and its implementation has remained largely ECHR compliant. It is designed to protect individuals' autonomy from inappropriate and disproportionate nonconsensual intrusions but its scope is largely limited to this. However, since the legislation was enacted at the start of the twenty first century the UK subsequently ratified the UN Convention on the Rights of Persons with Disabilities (CRPD) which requires the law and related practice to focus on giving effect to all the rights of persons with mental disabilities (people living with psychosocial, cognitive and intellectual disabilities) on an equal basis with others and to actively support such equality in rights enjoyment. The Terms of Reference of the independent Scottish Mental Health Law Review (2019-2022) included considering and making recommendations to align Scotland's mental health and capacity legislation with the CRPD. After engaging widely with stakeholders its recommendations sought to strengthen the voice of persons who use services and of those who care for them, reduce the need for non-consensual measures and secure rights to the help and support necessary to live a good life. In order to achieve this, it recommended, amongst other things, a refocusing on mental health and capacity law together with a Human Rights Enablement, Supported Decision Making and Autonomous Decision Making framework.


Asunto(s)
Derechos Humanos , Competencia Mental , Humanos , Escocia , Derechos Humanos/legislación & jurisprudencia , Competencia Mental/legislación & jurisprudencia , Personas con Discapacidad/legislación & jurisprudencia , Salud Mental/legislación & jurisprudencia , Naciones Unidas , Servicios de Salud Mental/legislación & jurisprudencia
18.
Int J Law Psychiatry ; 93: 101966, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38430626

RESUMEN

The Convention on the Rights of Persons with Disabilities (CRPD) sets out a new vision for mental health care with equality and self-determination as its core standards. The CRPD fundamentally challenges long-standing practices in Sweden including the use of involuntary hospitalization, treatment without consent, and the use of restraints. This article discusses the impact of this new vision on Swedish mental health law and policy. An examination of mental health law inquiries from 2008 to 2023 reveals a notable lack of attention from policymakers towards the CRPD. Nevertheless, the Convention has emerged as a vital advocacy instrument for disability organizations and others opposing proposals that seek to broaden doctors' authority to employ coercion. In addition, the many efforts undertaken to reduce the use of coercion and to enhance the involvement of individuals with psychosocial disabilities in policy development align seamlessly with the principles of the Convention. This article concludes with a reflection on why the CRPD has not assumed a more prominent role in shaping mental health law in Sweden and calls on the government to seriously consider the CRPD's call for equality.


Asunto(s)
Personas con Discapacidad , Salud Mental , Humanos , Suecia , Naciones Unidas , Derechos Humanos
19.
Wiad Lek ; 77(1): 126-134, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38431817

RESUMEN

OBJECTIVE: Aim: To determine the problematic issues of ensuring the rights and freedoms of persons suffering from mental disorders and to whom CMM are applied in criminal proceedings under the legislation of Ukraine and the legislation of the states that adhere to the modern concepts of international standards of human rights ensuring to a person the CMM are applied to. PATIENTS AND METHODS: Materials and Methods: Legal positions of the ECHR, criminal procedural legislation of a number of states, and a survey of scientists and practitioners conducted by the authors are used in this paper (total number of respondents was 168). A set of general scientific and special methods are used to achieve the aim of the study. CONCLUSION: Conclusions: The practice of applying СMM to persons suffering from mental disorders in criminal proceedings in Ukraine and other states does not fully meet international standards and needs improvement. It was suggested to make changes to the legal acts on the use of CMM in criminal proceedings.


Asunto(s)
Criminales , Trastornos Mentales , Médicos , Humanos , Derechos Humanos , Ucrania , Trastornos Mentales/terapia
20.
Child Adolesc Ment Health ; 29(2): 200-202, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38475676

RESUMEN

People of all ages are subject to involuntary psychiatric detention and treatment worldwide but there is current discussion about whether this complies with modern human rights law. The use of involuntary psychiatric hospitalisation among children and young people has largely eschewed research and policy interest to date. In this debate section, we hear from people with experience of child mental health services in the UK, USA and low- and middle-income countries about their views on the use of involuntary treatment in young people.


Asunto(s)
Tratamiento Involuntario , Salud Mental , Niño , Humanos , Adolescente , Internamiento Obligatorio del Enfermo Mental , Derechos Humanos , Políticas
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