A/HRC/40/54
tantrums, yelling or self-injury) as well as public displays of poverty and lack of support
(e.g. lack of maintenance of properties).26 If persons with disabilities violate such codes of
conduct, they can face criminal penalties, including fines, community service or even arrest.
Accumulation of minor offences may lead to deprivation of liberty. 27 Moreover, persons
with disabilities are repeatedly criminalized because the police take their non-compliant
behaviour as a threat.28 Persons with epilepsy or who are deaf have also been mistaken as
unruly.29
35.
Prevention of suicide and self-harm are common justifications for compulsory
admission into psychiatric facilities. However, medical literature cannot provide strong
evidence on whether the risk for suicide decreases after involuntary treatment. 30 Moreover,
a number of studies reported higher rates of suicide after psychiatric hospitalization. 31
Negative subjective experiences with compulsory admission can further lead to lower rates
of seeking or using services from the mental health system. Additionally, there is
compelling evidence that suicide is very difficult, if not impossible, to predict. 32 Prevention
of suicide demands comprehensive multisectoral strategies, including safe and supportive
spaces to discuss suicide and self-harm, free from any potential coercive intervention.
36.
Liability for malpractice and the ensuing risk management philosophy have proven
to be a galvanizing factor. In many jurisdictions, preventing people from harming
themselves is within the scope of the duty of care of service providers and families. This
increasing prospect of liability is making service providers err on the side of caution and
thus to resort to coercive measures. Furthermore, suicide rates increase when potential tort
liability is expanded to include mental health professionals, as those facing potential
liability may choose not to work with individuals considered to be at high risk of suicide. 33
37.
The interplay between disability and other identity traits produces further
inequalities in the enjoyment of the right to personal liberty. Based on gender and disability
stereotypes, women with disabilities are at risk of being viewed as “burdens” and being
placed in psychiatric facilities or other institutions, including the idea that they are unable to
fulfil the traditional role of mother and caregiver. Similarly, many older persons with
disabilities are placed in institutions or confined within homes, owing to prejudices based
on both age and disability. There are many reports of minority populations being
overrepresented in psychiatric facilities.34
26
27
28
29
30
31
32
33
34
A. Fang, “Hiding homelessness: ‘quality of life’ laws and the politics of development in American
cities”, International Journal of Law in Context, vol. 5, No. 1 (2009), pp. 1–24.
Australia, Parliament of Victoria, Law Reform Committee, Inquiry into Access to and Interaction
with the Justice System by People with an Intellectual Disability and their Families and Carers
(2013).
S. Krishan and others, “The influence of neighbourhood characteristics on police officers’ encounters
with persons suspected to have a serious mental illness”, International Journal of Law and Psychiatry,
vol. 37, No. 4 (2014), pp. 359–369; and K. Gendle and J. Woodhams, “Suspects who have a learning
disability: police perceptions toward the client group and their knowledge about learning disabilities”,
Journal of Intellectual Disabilities, vol. 9, No. 1 (2005), pp. 70–81.
S. Nevins, “The US prison system perpetuates ‘the criminalization of disability’”, 14 November 2014.
D. Giacco and S. Priebe, “Suicidality and hostility following involuntary hospital treatment”, PLOS
One, vol. 11, No. 5 (2016); C. Katsakou and S. Priebe, “Outcomes of involuntary hospital admission
– a review”, Acta Psychiatrica Scandinavica, vol. 114, No. 4 (2006), pp. 232–241.
D. Chung and others, “Suicide rates after discharge from psychiatric facilities: a systematic review
and meta-analysis”, JAMA Psychiatry, vol. 74, No. 7 (2017), pp. 694–702.
M. Chan and others, “Predicting suicide following self-harm: systematic review of risk factors and
risk scales”, British Journal of Psychiatry, 209 (4) (2016), pp. 277–283.
S. Dillbary, G. Edwards and F.E. Vars, “Why exempting negligent doctors may reduce suicide: an
empirical analysis”, Indiana Law Journal, vol. 93, No. 2 (2018).
R. Gajwani and others, “Ethnicity and detention: are Black and minority ethnic (BME) groups
disproportionately detained under the Mental Health Act 2007?”, Social Psychiatry and Psychiatric
Epidemiology, vol. 51, No. 5 (2016), pp. 703–711; L. Snowden, J.F. Hastings and J. Alvidrez (2009),
“Overrepresentation of black Americans in psychiatric inpatient care”, Psychiatric Services, vol. 60,
No. 6 (2009), pp. 779–785.
9
Select target paragraph3
Connect to a paragraph
Connect to an entity
Disable highlights
Add to table of contents