“All human beings are born free and equal in dignity and rights”.

UDHR (1948)

HUMAN RIGHTS OF THE MENTALLY ILL

Ramachandra Associate Professor Dept of Nursing

What are Human rights?

Human rights are "basic rights and freedoms that all people are entitled to regardless of nationality, sex, national or ethnic origin, race, religion, language, or other status."These rights are all interrelated, interdependent and indivisible.

What is mental illness?

A mental disorder or mental illness is a psychological or behavioral pattern generally associated with subjective distress or disability that occurs in an individual, and which is not a part of normal development or culture.

The International Bill of Human Rights

The Universal Declaration of Human Rights

The International Covenant on Economic, Social and Cultural Rights

The International Covenant on Civil and Political Rights.

Since the dawn of human civilization, mentally ill

patients have received the scant care and concern

of the community because of their unproductive

value in the socio-economic value system.

They have not only been neglected but received

step motherly treatment from the health planners

especially in the developing countries.

The mentally ill person deserves the same

privileges as enjoyed by any other human being.

They include a right to better and more accessible

care, to good recovery and increased hopes of

reintegration into society.

However, the Stigma, residual disability and

its intolerance, and more importantly the

inability of the mentally ill to protest against

exploitation, have all made basic human

rights of the mentally ill a major cause of

growing concern.

HUMAN RIGHTS OF MENTALLY ILL

1. Right to communicate with people outside the

hospital through correspondence, telephone, and

personal visits

2. Right to wear clothing and personal effects with

them in the hospital

3. Right to religious freedom

4. Right to be employed if possible

5. Right to manage and dispose of property

6.Right to execute bills

7.Right to enter into contractual relationships

8.Right to make purchases

9.Right to education

10.Right to habeas corpus

11.Right to independent psychiatric examination

12.Right to civil service status

13.Right to retain licences, privileges, or permits

established by law, such as a driver’s or

professional licence

14.Right to sue or be sued

15.Right to marry and divorce

16.Right not to be subject to unnecessary

mechanical restraints

17.Right to periodic review of status

17.Right to legal representation

18.Right to privacy

19.Right to informed consent

20.Right to treatment

21.Right to refuse treatment

22.Right to treatment in the least restrictive setting

Right to Communicate With People outside the Hospital

This right allows patient to visit and hold telephone

conversations in privacy and send unopened letters

to anyone of their choice, including judges, lawyers,

families, and staff. The hospital also can limit the

times when telephone calls are made and received

and when visitors can enter the facility.

Right to Keep Personal Effects

The patient may bring clothing and personal items to

the hospital, taking into consideration the amount of

storage space available. The hospital is not responsible

for their safety, and valuable items should be left at

home.

Right to Enter Into Contractual Relationships

The court considers contracts valid if the person understands the circumstances of the contract and its consequences.

To prove incompetence in court, all of the following must be shown:1.The person has a mental disorder.2.This disorder causes a defect in judgment.3.This defect makes the person incapable of handling personal affairs.

Right to Education

Many patient exercises the right to education on

behalf of their emotionally ill or mentally

retarded children.

Right to Habeas Corpus

Habeas corpus is an important constitutional right

patients retain in all states even if they have been

involuntarily hospitalized. It provides for the speedy

release of any person who claims to be detained

illegally.

Right to Privacy

The right to privacy implies the person’s right to

keep some personal information completely secret

or confidential.

Confidentiality involves the nondisclosure of

specific information about a person to someone else

unless authorized by that person

The Health Insurance Portability and Accountability Act (HIPAA,2003)

1.To be educated about HIPAA privacy protection

2.To have access to their own medical records

3.To request correction or amendment of their health

information to which they object

4.To require their permission for disclosure of their

own personal information.

Right to Informed Consent

The goal of informed consent is to help patients

make better decisions.

Informed consent means that a clinician must give

the patient a certain amount of information about the

proposed treatment and must attain the patient’s

consent, which must be informed, competent, and

voluntary.

Information to be disclosed in Obtaining Informed Consent

Diagnosis

Description of the patient’s problem

Treatment

Nature and purpose of the proposed

treatment

Consequences

•Risks and benefits of the proposed treatment including physical and psychological effects, costs, and potential resulting problems•Alternatives•Viable alternatives to the proposed treatment and their risks and benefits•Prognosis•Expected outcomes with treatment, with alternative treatments, and without treatment.

Information to be disclosed in Obtaining Informed Consent

Diagnosis

Description of the patient’s problem

Treatment

Nature and purpose of the proposed

treatment

Consequences

Risks and benefits of the proposed treatment

Alternatives

Viable alternatives to the proposed treatment and

their risks and benefits

Prognosis

Expected outcomes with treatment, with alternative

treatments, and without treatment.

Right to Treatment

The courts defined three criteria for adequate

treatment:

1.A humane psychological and the physical

environment

2.A qualified staff with a sufficient number of

members to administer adequate treatment

3.Individualized treatment plans

Right to Refuse Treatment

The relationship between right to treatment

and right to refuse treatment is complex.

The right to refuse treatment includes the

right to refuse involuntary hospitalization. It has

been called the right to left alone.

The involuntary therapy conflicts with two

basic legal rights: freedom of thought and

the right to control one’s life and actions as

long as they do not interfere with the rights

of others.

Right to Treatment in the Least Restrictive Setting

Its goal is evaluating the needs of each patient

and maintaining the greatest amount of personal

freedom, autonomy, dignity, and integrity in

determining treatment.

This right applies to both hospital-based and

community programs.

Role of Nursing

The National League for Nursing (1977) issued a statement on the nurse’s role in patient’s rights.

Right to health care that is accessible and meets professional standards, regardless of the setting

Right to courteous and individualized health care

that is equitable, humane, and given without

discrimination based on race, color, creed, sex,

national origin, source of payment, or ethical or

political beliefs

Right to information about their diagnosis,

prognosis, and treatment, including alternatives

to care and risks involved

Right to information about the qualifications,

names, and titles of health care personnel

Right to refuse observation by those not directly

involved in their care

Right to coordination and continuity of health care

Right to information on the charges for services,

including the rights to challenge these charges

Above all, the right to be fully informed about all

their rights in all health care settings.

Perhaps the most important factors in

ensuring patient’s rights are the attitude,

knowledge, and commitment of the mental

health professional

Ramachandra Associate Professor

Dept of Nursing

“All human beings are born free and equal in dignity and rights”.

UDHR (1948)

What are Human rights?

• Human rights are "basic rights and freedoms that all people are

entitled to regardless of nationality, sex, national or ethnic origin, race, religion, language, or other status.“

• These rights are all interrelated, interdependent and indivisible.

What is mental illness?

• A mental disorder or mental illness is a psychological or behavioral pattern generally associated with subjective distress or disability that occurs in an individual, and which is not a part of normal development or culture.

The International Bill of Human Rights

• The Universal Declaration of Human Rights,• The International Covenant on Economic,

Social and Cultural Rights,• The International Covenant on Civil and

Political Rights .

• Since the dawn of human civilization, mentally ill patients have received the scant care and concern of the community because of their unproductive value in the socio-economic value system.

• They have not only been neglected but received step motherly treatment from the health planners especially in the developing countries.

• The mentally ill person deserves the same privileges as enjoyed by any other human being.

• They include a right to better and more accessible care, to good recovery and increased hopes of reintegration into society.

• However, the Stigma, residual disability and its intolerance, and more importantly the inability of the mentally ill to protest against exploitation, have all made basic human rights of the mentally ill a major cause of growing concern