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Are Human Rights Infringed in Treatments for Mental Health?

In: Social Issues

Submitted By duemy
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Many situations experienced by people living with mental health problems involve human rights. However, there is little information available about human rights and how they relate to mental health. Too often, a person may not realise that they are able to do something about their situation, or even that there is something wrong with the way they are being treated. It is therefore vital that people living with mental health problems are able to access information about their human rights and challenge bad treatment. {BIHR, 2006, P.4}.

What are Human Rights?

* They belong to everyone. * They are based on principles of fairness, equality, dignity, and respect. * They are about how public authorities – including the Government, hospitals and social services – must treat you.

* They prevent authorities from doing certain things to you, like treating you in a degrading way.

* They also sometimes force authorities to take certain actions, like taking steps to protect your life.

* They were first legally defined by international agreement after the horrors of the Second World War.

* Since the Second World War, there have been many different international human rights agreements.

* One of the most important human rights agreements is the European Convention on Human Rights.

The basic rights and freedoms, to which all humans are entitled, often held to include the right to life and liberty, freedom of thought and expression, and equality before the law. {American heritage, 2000}. The British Institute of Human Rights describe the relevance of human rights:

The Human Rights Act is vital to protecting the fundamental freedoms of everyone in society. The Act is particularly important for people with experience of mental distress, who are too often denied their human rights, such as the right not be discriminated against (article 14), the right to a private and family life (article 8), or, in extreme cases, the right to liberty (article 5), {Mind, 2013}.
People with mental health problems are usually denied these rights. They do not have a say in their treatment, it is believed that the professionals have to make decisions for them, in the name of ‘best interest’.
Human Rights and Mental Health
Mental health refers to our cognitive or emotional wellbeing - it is all about how we think, feel, and behave. Mental health, if somebody has it, can also mean an absence of a mental disorder. Approximately 25% of people in the UK have a mental health problem during their lives. {Medical, 2013}.
Mental disorder is defined as ‘any disorder or disability of mind'. This definition includes conditions such as schizophrenia, depression, bipolar disorder, anxiety disorder, obsessive-compulsive disorder, eating disorders, personality disorders, autistic-spectrum disorders, organic disorders such as dementia, behavioural changes due to brain injury, and mental disorders due to drug use. The definition includes learning disability only where it is associated with abnormally aggressive or seriously irresponsible behaviour. {Ibid}.
There are many issues surrounding people with mental health problems, which are still a major cause of concern.
The Use of restraint and treatment of the mentally ill
People with mental disorders are exposed to a wide range of human rights violations. This often occurs in psychiatric institutions through inadequate, degrading, and harmful care and treatment as well as unhygienic and inhuman living condition {WHO, 2006}. You have the absolute right not to be tortured or subjected to treatment or punishment, which is inhuman or degrading. In some instances, the use of restraint–physical or otherwise – may also amount to inhuman or degrading treatment. Examples include tying you to a chair to prevent you from moving, or continually giving you medication to keep you sedated because there is a lack of staff {BIHR, P.14}.

Case Example:
A man sectioned with a mental illness, who also had a heart condition, was given a particular drug as part of a medical trial. He objected and had to be held down to have the drug injected. A court said that this type of situation could give rise to a breach of the right not to be treated in an inhuman or degrading way. The court also said that a patient in these circumstances should have the opportunity to challenge the decision at a hearing where the specialists could be cross-examined.
This hearing may occur before or after the treatment takes place.
{Ibid, P.16}

Should people with mental problem not have the right to object to the treatment they get?
Detention
If you are detained under the Mental Health Act this means you are admitted to hospital against your will. Detention under the Mental Health Act is commonly known as ‘being sectioned’. {Ibid}. Which means those with mental disorders lack the capacity to make decisions, so every of such decisions are made on their behalf. So where are the rights of fairness, equality, dignity, and respect?
Stigmatisation and aftercare
Stigma and prejudice contribute to the fundamental abuse of human rights that sadly continue to be seen in some of the outdated large psychiatric institutions and social care homes that remain the mainstay of mental health systems in some Member States.
This abuse manifests itself in many ways; even where community based care dominates, as in much of Western Europe, individuals can be just as neglected and isolated within their communities as they were previously in institutions. Stigma can affect all aspects of life, limiting access to employment and housing, harming, social relationships, and reducing self-esteem. Fear of being labelled as having a mental health problem also reduces the likelihood of individuals with mental health disorders seeking treatment {David, n. d}.

Section 117 of the Mental Health Act 1983 (MHA) places a joint legal duty on the NHS and social services to provide free aftercare services to people who have been detained under sections 3, 37, 45A, 47 or 48 of the Act. There is no definition of aftercare in the legislation, but services could include crisis-planning, accommodation, help with managing money and services to meet other needs, such as psychological needs. The section 117 duty lasts as long as someone needs aftercare services for their mental health condition. It can only end when both the health and social services authorities have assessed that someone is no longer in need of aftercare services {Rethink, n. d.}.

What are Ethics? And its application to Human Rights and Mental illness
Ethics is the branch of study dealing with what is the proper course of action for man. It answers the question, "What do I do?" It is the study of right and wrong in human endeavours. At a more fundamental level, it is the method by which we categorize our values and pursue them. Do we pursue our own happiness, or do we sacrifice ourselves to a greater cause? Is that foundation of ethics based on the Bible, or on the very nature of man himself, or neither? {Jeff, et al. 2001}. How does this then apply to human rights and mental illness?
Situation ethics (contextualism) - The right thing to do depends on the situation.
In situation ethics, right and wrong depend upon the situation. There are no universal moral rules or rights - each case is unique and deserves a unique solution. Situation ethics rejects 'prefabricated decisions and prescriptive rules'. It teaches that ethical decisions should follow flexible guidelines rather than absolute rules, and be taken on a case-by-case basis {BBC, 2013}. In situation ethics, the right thing to do to a mentally ill patient is to approach the situation as it is. Either by using force or other means to achieve the end result.

Kantian ethics - duty rather than emotions or end goals.
Kant believed that there was a supreme principle of morality and he referred to it as ‘The Categorical Imperative’ {Kantian ethics, n. d}. This determines what our moral duties are. What then is our moral duty in assisting the mentally ill without infringing on their rights? Utilitarianism ethics- the greatest happiness for the greatest number of people. Jeremy Bentham and John Stuart Mill believed that an action is right if it tends to promote happiness and wrong if it tends to produce the reverse of happiness—not just the happiness of the performer of the action but also that of everyone affected by it. So how do the mentally ill decide when decisions are made on their behalf for the greater good? In response to a student's question regarding choosing a psychiatric specialty, a charge nurse states, "Mentally ill clients need special care. If I were in that position, I would want a caring nurse also." From which ethical framework is the charge nurse operating? The charge nurse is operating from a Christian ethics framework. The imperative demand of Christian ethics is to treat others as moral equals by permitting them to act as we do when they occupy a position similar to ours. Kantianism states that decisions should be made based on moral law and that actions are bound by a sense of moral duty. Utilitarianism holds that decisions should be made focusing on the end result being happiness. Ethical egoism promotes the idea that what is right is good for the individual {Quizlet, 2013}. Word count: 1,534.

References
American Heritage, 2000. American Heritage dictionary of the English Language: Houghton Mifflin Company {Online}. Available at: <http://www.thefreedictionary.com/human+rights>
{Accessed: 01 April 2013}.

BBC, {2013}. Ethics guide. {Online}. Available at:
<http://www.bbc.co.uk/ethics/introduction/situation_1.shtml> {Accessed: 30 March 2013}.

British Institute of Human Rights, {2006}.Your Human Rights: A guide for people living with mental health problems. PP.4, 14, 16 {Online}. Available at:
<http://www.bihr.org.uk/sites/default/files/bihr_mental-health_guide.pdf>
{Accessed: 30 March 2013}.

Daniel W., S., 1992. Attitudes towards the mentally ill: The effects of label and beliefs. {Online}. Available at:< http://www.jstor.org/discover/10.2307/4121327?uid=3738032&> {Accessed: 30 March 2013}.

David, M., n. d. Countering the stigmatisation and discrimination of people with mental health Problems in Europe. {Research paper} {pdf}.Directorate-General for Health & Consumers. Available at: <http://ec.europa.eu/health/archive/ph_determinants/life_style/mental/docs/stigma_paper_en.pdf> {Accessed: 05 April 2013}.

Encyclopaedia Britannica, 2013. Encyclopaedia Britannica Online. {Online} London: Encyclopaedia Britannica {UK} Available at: <http://www.britannica.com/EBchecked/topic/620682/utilitarianism>
{Accessed: 30 March 2013}.

Jeff, L., Joseph R., Importance of Philosophy, 2001. Ethics. {Online}. Available at:
<http://www.importanceofphilosophy.com/Ethics_Main.html>
{Accessed: 05 April 2013}. Kantian ethics, n. d. {Online}. Available at: <http://www.csus.edu/indiv/g/gaskilld/ethics/Kantian%20Ethics.htm> {Accessed: 30 March 2013}.

Medical News Today, 2013. What Is Mental Health? What Is Mental Disorder? [Online}. Available at: <http://www.medicalnewstoday.com/articles/154543.php>
{Accessed: 01 April 2013}.

Mind, 2013. The Human Rights Act. {Online}. Available at:
<http://www.mind.org.uk/policy/equality_and_human_rights/the_human_rights_act>
{Accessed: 01 April 2013}.

Quizlet, 2013. Ethical and Legal Issues in Psychiatric/Mental Health Nursing {online}. Available at:
<http://quizlet.com/17215123/2204-ethical-and-legal-issues-in-psychiatricmental-health-nursing-flash-cards/>
{Accessed: 31 March 2013}.

Rethink Mental illness, n. d. Detention under the Mental Health Act. {Factsheet}. {Online}. Available at: <www.rethink.org> {Accessed: 01 April 2013}.

Rethink Mental illness, n. d. Section 117 Aftercare. {Factsheet}. {Online}. Available at:
<www.rethink.org/document.rm?id=7291>
{Accessed: 05 April 2013}.

United Nation, The Universal Declaration of Human Rights. {Online}. Available at: <http://www.un.org/en/documents/udhr/> {Accessed: 30 March 2013}.

Who, 2006. Mental Health and Human Rights Project. {Online}. Available at:
<http://www.who.int/mental_health/policy/mental_health_and_human_rights October 2006.pdf> {Accessed: 30 March 2013}.

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