Authors: Alan Rosen
Year: 2019
Event: 2019 TheMHS Conference
Subject: Human Rights & Mental Health Services: A Double-Whammy Recolonisation for Marginalised Populations?
Type of resource: Conference Presentations and Papers
Abstract: Alan has close to 30 years of experience as a Senior Specialist Psychiatrist, Service Director, and then Director of Clinical Services of the Royal North Shore Hospital and Community Mental Health Services. In March 2013, he was appointed Deputy Commissioner of the Mental Health Commission of New South Wales. He has reviewed mental health services for governments and administrations in 5 Australian states and the ACT. He has been invited speaker and/or performed consultancies on service development in several Australian states and territories, UK, Ireland, Netherlands, Sweden, Denmark, Italy, USA, Canada, China, Thailand, Hong Kong, Argentina, Spain and New Zealand. He is the author or co author of more than 120 published and submitted journal articles or chapters on studies of 24 hour community based alternatives to acute and long term inpatient care, rehabilitation and recovery, assertive case management and integrated mental health service systems; more inclusive interdisciplinary mental health teams, including peer workers, early intervention in psychosis; psychiatric stigma; dual disorders, deinstitutionalization, consumer issues, family interventions, Aboriginal, developing country, rural and remote mental health, cultural influences on mental health service systems, qualitative and quantitative outcome measures, recovery measurement, impaired doctors, research and evaluation in mental health, service standards, the National Mental Health Strategy, Global community psychiatry, Human Rights of individuals with severe and persistent mental illnesses, international comparisons between Mental Health Commissions, and the history of Australian Psychiatry. Alan has been involved with TheMHS since 1991 as a founding committee member. He has presented at the TheMHS Conferences and Summer Forums on a wide variety of topics since its inception.
The modern human rights framework, based on respect for inherent dignity of all humans, was crystallized by the United Nations through Universal Declaration of Human Rights in 1948. The UN Convention on the Rights of Persons with Disabilities (CRPD) 2006 embedded the rights of individuals with disabilities, including mental disabilities, into the international law. However, people with mental disabilities, especially the most disadvantaged groups e.g. Indigenous peoples, the homeless, prisoners, refugees and asylum seekers continue to face gross violation of their human rights. For example, Maori people in New Zealand and Aboriginal and Torres Strait Islander people in Australia are significantly more likely to be subject to compulsory psychiatric treatment and experience seclusion. This double whammy of having a mental disability and being marginalized has been called ‘re-colonization of marginalized populations’.
Minimizing/eliminating involuntary treatment and seclusion/restraint require systematic voluntary options e.g. community-based and recovery-oriented mental health services and legislation that incorporates a respect for individual autonomy through advance health directives and supported decision-making principles. In addition, the government policies at all levels must promote empowerment, social inclusion and economic participation of individuals with mental disabilities and vulnerable population groups by promoting positive rights to housing, healthcare, education and employment. Most importantly, society at large has to commit to inclusive human development and social equity, especially for disadvantaged individuals facing capability deprivation.
This symposium will discuss the violations of human rights faced by vulnerable populations and identify potential solutions to ‘close the gap’ by focusing on legislation, policy and practice.
References
Rosen, A. 100% Mabo: Decolonising of People with Mental Illness and their Families, A.N.Z.J. Fam. Ther. 15:3:128-142. l994.
Rosen, A. Urban marginality mirrors remote, indigenous and global marginality of people with mental illness : the Australian experience, 1st International Scientific Forum SOUQ on Urban suffering, human rights and good governance, 23-24-25 May 2011.
Mezzina R, Rosen A, Amering M, et al. (2018) The Practice of Freedom: Human Rights and the Global Mental Health Agenda. In: Javed A and Fountoulakis K (eds) Advances in Psychiatry. Springer, Cham, 483-515.
Gill NS. Human rights framework – an ethical imperative for psychiatry. Australian and New Zealand Journal of Psychiatry. 2019, Vol 53 (I) 8-10
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