Transcript Torture and ill-treatment in psychiatry Tina Minkowitz Welcome “absolute ban” • Absolute ban on nonconsensual psychosurgery, electroshock, mind-altering drugs including neuroleptics, restraint and solitary confinement.

Torture and ill-treatment in
psychiatry
Tina Minkowitz
Welcome “absolute ban”
• Absolute ban on nonconsensual psychosurgery,
electroshock, mind-altering drugs including
neuroleptics, restraint and solitary confinement longand short-term
• Replace forced treatment and commitment with
services that meet expressed needs, respect autonomy,
alternatives to medical model
• CRPD as authoritative guidance
• Treatment that violates CRPD cannot be justified as
medical necessity
• Revise contrary legal provisions
Concerns
• Contradiction with CRPD in paragraph 69, impacts
on recommendations
• “Necessity to protect the person or others” is a
red herring and masks the discriminatory and
violent character of detention based on “mental
illness” or “unsoundness of mind”
• Lack of clarity re legal capacity and informed
consent in paragraphs 27 and 66, CRPD does
away with “incapacity”
Civil commitment/detention
• CRPD prohibits all forced and coercive
interventions in mental health services,
including civil commitment/detention
• Mandate formerly recognized that psychiatric
detention was within the scope of acts causing
severe pain and suffering
• Mandate in current report unqualifiedly
rejects detention of drug users
“Danger to self or others”
• Standard created to justify psychiatric
detention
– Part of MI Principles, overruled by CRPD
• Labeling any person as dangerous is character
assassination, unjustifiable and arbitrary
• Psychiatric profiling and other profiling
How do we respond to suicide and
violence?
• Non-discriminatory standards, larger social
conversation – not about “mental health”
• Preventive detention too serious an
infringement on human rights, causes
suffering and violence, not a solution
• Intervening to stop an act of violence or
suicide is not the same as detention
• Safe spaces to explore suicidal feelings or
intent – detention is not a safe space
Recommendations
• Uphold CRPD standards requiring the repeal of
civil commitment and incapacity/ substituted
decision-making
• Publicize and implement absolute ban on
nonconsensual psychiatric interventions, and
obligation to replace forced treatment and
commitment by services that respect autonomy
• Raise awareness about psychiatric profiling and
its relationship to civil commitment, explore
safety, mutuality and autonomy