Involuntary mental health treatment in the era of the United Nations Convention on the Rights of Persons with Disabilities

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Summary points

  • The introduction of the United Nations (UN) Convention on the Rights of Persons with Disabilities (CRPD) and General Comment 1 on Article 12 (GC1) has generated considerable debate regarding the assertion that people with psychosocial disabilities (disabilities arising from mental health conditions) always possess decision-making capacity.
  • While there is debate over the feasibility and acceptability of supported decision-making, stakeholders interviewed for this study suggested that coercive treatment is heavily overutilized and that there needs to be more dialogue between holders of divergent positions.
  • There are a number of important unresolved questions relating to more complex cases and to whether the right guaranteed by the CRPD is absolute and immediate or subject to limitations.
  • Ensuring participation of all key stakeholders is essential to realizing the pluralistic vision of the CRPD, as is research focusing on implementation of supported decision-making regimes, particularly in low- and middle-income countries. Training on the provisions of the CRPD is also needed to ensure implementation, and addressing stigmatized beliefs among policy makers about the decision-making and cognitive abilities of mental healthcare users (MHCUs) is critical.

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