A/HRC/34/32
disabilities. 58 Evidence shows that the provision of interdisciplinary and demedicalized
services in the community enables users to remain connected with their families, to
maintain employment and generally to remain close to the support networks which
facilitate early treatment and recovery. Mental health services, particularly in more
developed countries and, increasingly, in developing countries, are usually provided within
specialized systems centred around psychiatric hospitals, in which many practices
contradictory to the standards in the Convention on the Rights of Persons with Disabilities
continue to take place. In order to guarantee the right to access to services for persons with
mental health conditions and psychosocial disabilities, States should ensure the availability
of recovery-based treatment in the community and in the primary care system.
3.
Deinstitutionalization
55.
The implementation of article 19 of the Convention on the Rights of Persons with
Disabilities on the right to live independently and to be included in the community is
essential for persons with psychosocial disabilities. The recovery approach is consistent
with the purpose of supporting the person in all aspects of their life, personal development,
exercise of autonomy and participation and inclusion in the community.
56.
Ensuring that persons with disabilities choose where and with whom they live and
upholding autonomy fosters inclusion in the community. Institutionalization and
institutionalized living arrangements, whether in large facilities or smaller group homes,
amount to segregation and are inconsistent with inclusion in the community. The
Committee on the Rights of Persons with Disabilities has repeatedly expressed concern
about the institutionalization of persons with disabilities and the lack of support services in
the community, and has recommended implementing support services and effective
deinstitutionalization strategies in consultation with organizations of persons with
disabilities.59
57.
Effective deinstitutionalization requires an understanding that the right to
community living is more than just access to a physical placement in the community. 60
Social support for persons with psychosocial disabilities must be made available at the
same time, including supported and assisted housing, health care, crisis response systems,
income support, support for social networks and access to education and work. 61 Social
networks, peer support, circles of support and local community support are valuable, in
particular to address situations of crisis and emergency; they must be acknowledged and
their development supported.
4.
Children
58.
At least 8 million children live in institutions. 62 The Special Rapporteur on the right
of everyone to the enjoyment of the highest attainable standard of physical and mental
health has reported that institutional care in early childhood has such harmful effects that it
should be considered a form of violence against young children. 63 In accordance with
international human rights and good practice norms, States should (a) end the
institutionalization of all children, with and without disabilities; (b) place a moratorium on
58
59
60
61
62
63
16
See general comment No. 14, para. 12 (b).
See, for example, CRPD/C/ESP/CO/1, paras. 35-36; CRPD/C/CHN/CO/1, para. 26;
CRPD/C/ARG/CO/1, para. 24.
Ibid.
WHO and World Bank, World Report on Disability (2011), p. 148.
See A/61/299, para. 55.
See A/70/213, para. 73.
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