Human Rights of people with mental ill-health must be respected

Dail Eireann Second Stage Debate on Irish Human Rights and Equality Commission Bill 2014. 9th April 2014

 Deputy Dan Neville: I welcome this opportunity to contribute to the debate.  I will deal in particular with the human rights of people with disabilities.  I will compare international law with the situation in Ireland.  Under international law, Ireland has a responsibility towards everyone under its jurisdiction.  These international obligations exist in addition to those in Ireland’s domestic law and the 1937 Constitution.  Where there is a conflict, international law is superior.  Even if international standards are not expressly reflected in domestic law, they are binding on states once they are ratified.  Each general international human rights instrument protects the rights of persons with mental illness through the principle of equality and non-discrimination.  More specific standards exist with regard to people with mental illness.

The primary source of international human rights under the United Nations system is the Universal Declaration of Human Rights, which is frequently quoted and which encompasses civil, political, economic, social and cultural rights.

Civil and political rights, including the right to liberty, a fair trial and to vote, were subsequently laid down in the International Covenant on Civil and Political Rights, to which I will refer, and the committee of experts was established to oversee its implementation in national jurisdictions.  Economic, social and cultural rights, including the right to an adequate standard of living, the highest attainable standard of physical and mental health and an education, were laid down in the second binding treaty, namely, the International Covenant on Economic, Social and Cultural Rights, and a similar supervisory committee was established, namely, the United Nations Committee on Economic, Social and Cultural Rights.  These UN committees are supported by the UN High Commission for Human Rights which also issues comments that are instructive.

Other treaties are of relevance.  For example, the UN Commission on the Rights of the Child, often quoted in this House, carries certain additional obligations.  The International Covenant on Civil and Political Rights states the obligation on states parties to the covenant to promote progressive realisation of the relevant rights to the maximum of their available resources clearly requires governments to do much more than merely abstain from taking measures that might have a negative impact on persons with disabilities.  The obligation in the case of such a vulnerable and disadvantaged group is to take positive action to reduce structural disadvantage and give appropriate preferential treatment to people with disabilities in order to achieve the objectives of full participation and equality within society for all persons with disabilities.  That almost invariably means that additional resources will need to be made available for that purpose and that a wide range of specially tailored measures will be required.

The UN principles for the protection of persons with a mental illness and the improvement of mental health care, known as the MI principles, were adopted in 1991 and state elaborate and basic rights and freedoms of people with a mental illness must be secured if states are to be fully compliant.  Many of the rights included in both covenants, including the UN instruments, include such measures as standard rules for the equalisation of opportunities for persons with disabilities, a declaration on the rights of mentally retarded persons, a declaration on the rights of disabled persons and the UN body of principles for the protection of all persons in any form of detention or imprisonment.  The relevant principle in regard to the rights of people with a mental illness is Article 12 of the International Covenant on Civil and Political Rights which provides for the rights of everybody to the enjoyment of the highest attainable standards of physical and mental health and identifies some of the measures states should take “to achieve a full realisation of these rights”.

The MI principles to which I referred apply to all persons with a mental illness, regardless of whether they are in inpatient psychiatric care, and to all persons admitted to psychiatric facilities, regardless of whether they are diagnosed as having a mental illness.  They provide criteria for the determination of mental illness, the protection of confidentiality, standards of care, the rights of people in mental health facilities and the provision of resources.  MI principle 1 lays down the basic foundations on which states’ obligations towards people with a mental illness are built.  It states all persons with a mental illness or who are being treated as such shall be treated with humanity and respect for the inherent dignity of the human person and shall have the right to exercise all civil, political, economic, social and cultural rights as recognised in the Universal Declaration of Human Rights.

In addition to the UN mechanism, Ireland is bound by certain human rights principles laid down by the Council of Europe.  There is a regional system of international human rights law comprising 43 states throughout Europe.  Chief among the Council of Europe’s treaties is the 1950 European Convention on Human Rights and Fundamental Freedoms.  Another is the European Convention for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment which pertains specifically to places of detention.  It has an expert committee, the European Committee for the Prevention of Torture and Inhuman and Degrading Treatment or Punishment.

Ireland’s treatment of people with a mental illness is part of a wider pattern of discrimination against people with disabilities.  Amnesty International uses the term “persons with disabilities” in accordance with contemporary UN usage which defines disability as summarising a great number of functional limitations occurring in any population in any country of the world.  People may be disabled by physical, intellectual or sensory impairment, medical conditions or a mental illness.  In general, Ireland’s treatment of people with disabilities is often at variance with international standards.  The concluding observations in the report of the UN Committee on Economic, Social and Cultural Rights on Ireland’s second periodical review were critical of Ireland’s treatment of people with disabilities.  It remarked on the persistence of discrimination against persons with physical and mental disabilities, especially in the fields of employment, social security benefit, education and health, and expressed concern that the principles of non-discrimination and equal access to health facilities and services were not embodied in the national mental health strategy.

The Minister might comment on the Government’s declared position on the repeal of the 2001 Mental Health Act in regard to criticisms of it and the need to have it upgraded.  I will raise that issue in a different forum at a later stage, probably in a Topical Issue debate.