A/HRC/39/36
13.
The Special Rapporteur on the rights of persons with disabilities, Catalina Devandas
Aguilar, agreed that coercion and exclusion had become the rule in the majority of mental
health systems, particularly in developed countries, and that involuntary interventions, such
as electroconvulsive therapies, psychosurgery, forced sterilization and other invasive,
painful and irreversible treatments, continued to be permitted, contrary to the Convention
on the Rights of Persons with Disabilities. In that regard, she expressed her opposition to
the initiative of the Council of Europe to draft an additional protocol to the Oviedo
Convention that would serve to legitimize those coercive practices, and called upon
member States of the Council of Europe to stand against it, as it represented an
unacceptable backward step in rights protection. She drew attention to good practices and
tools from within and outside the health system that offered solutions and support in crisis
or emergency situations, which were respectful of medical ethics and of the human rights of
the individual concerned, including of their right to free and informed consent. They
included programmes for personal assistance, psychosocial support and housing, which
reduced the risk of institutionalization and of being subjected to physical and sexual
violence. She recalled that the participation of persons with disabilities themselves was an
essential precondition for development based on human rights.
14.
The Special Rapporteur on torture and other cruel, inhuman or degrading treatment
or punishment, Nils Melzer, joined the other special rapporteurs in condemning as unlawful
forced institutionalization and any detention based on disability and noted that it may
amount to torture and ill-treatment. He drew attention to the fact that people with
psychosocial disabilities often lost their legal capacity, causing them to fall below the radar
of legal purview, including within court proceedings, which might result in “voluntary”
institutionalization through the consent of a third party, in being subjected to forced
medication for restraint or punitive purposes, and in other intrusive treatments such as
forced sterilization, abortion, contraception, or electroconvulsive therapy, which might also
amount to torture and ill-treatment.
15.
Bhargavi Davar, of Transforming Communities for Inclusion-Asia, drew particular
attention to the situation in the Asia-Pacific region, indicating that the traditional mental
health system and its biomedical approach had been imported through colonial frameworks
(e.g. incapacity laws and guardianship) and had been sustained through the growing trend
of pills and institutions fuelled by pharmaceutical interests. She warned that such practices
and mental health laws had led only to greater violence and violations, through new forms
of coercion and forced institutionalization. She recalled that legal capacity, liberty, equality,
non-discrimination and inclusion were rights belonging to everyone, as enshrined in human
rights instruments, and that the Convention on the Rights of Persons with Disabilities called
for all rights for all persons with disabilities, without exception. She underscored that old
practices led only to old outcomes, and for innovation to emerge, new approaches must be
adopted. She affirmed that reforming mental health and incapacity laws was not enough,
and called for their repeal and for a moratorium on new mental health laws. She cited
examples of emerging practices and called for further support for new community practices,
guidance and pilot programmes for deinstitutionalization, socially innovative caregiving
within communities, and a shift of mentality in all services linked to development and
human rights. She called for persons with psychosocial disabilities to be at the centre of,
and to lead, that transformation.
16.
Nina Ferencic, of UNICEF, recalled that mental ill-health was often a direct
consequence of violence, emotional neglect and ill-treatment experienced during childhood,
including due to institutionalization, and that it had a disproportionate impact on children
with disabilities, whose families often lacked information and support to raise their child at
home. She expressed concern about the criminalization, control and policing of mental
health, which had no parallels in other areas of health. She highlighted commonalities with
juvenile justice, where the majority of incarcerated youth had mental health or substance
use disorders and had experienced traumatic victimization, such as physical abuse,
domestic violence or neglect. She pointed to the need to implement approaches that would
reduce incarceration and provide youth with access to a broader range of measures to help
them grow and develop in the community. She suggested working across health, education,
social protection and legal systems and directly with children, youth, parents, teachers, care
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