Half of the complaints of mental health rights violations in Catalonia occur in the healthcare sector
Although there are conventions, rules and laws that recognize the need and obligation to guarantee the rights of people with mental health problems, their rights are often still violated.
With the aim of making these rights violations visible, the Federació Salut Mental Catalunya has analyzed the cases reported in 2022 in this Autonomous Community in the Report on Rights and Mental Health in Catalonia 2022 .
In 2022, 269 complaints were registered. Of these, 7 out of 10 were filed by women, and it is generally the affected person who files the complaint.
One of the most significant findings in this report is that 84.75% of the reported cases of violations occurred in the province of Barcelona (especially in its capital), continuing the trend of previous years. This may be due to the high population density, along with the greater number of guidance and counseling centers (Espai Situa't) available in this geographical area.
Slightly more than half of human rights violations typically occur in the healthcare sector. Therefore, the public administration itself, understood as the ultimate guarantor of the rights of the citizens it represents, is the most frequent perpetrator of these violations.
The reasons for discrimination are very diverse and several can occur simultaneously in the same situation of discrimination or rights violation. Thus, in 50% of cases, the violations were due to mental health reasons . These are followed by those motivated by institutional violence, the person's economic situation, disability, and gender identity.
The rights that have been violated most often are the right to a quality public service (22.57%), the right to moral (22.42%) and physical (16.14%) integrity, and the right to health (14.71%).
Intersectionality and violation of fundamental rights
It is important to consider the intersectionality of the individual, the social categorizations that generate oppression and inequality, especially when we talk about people with mental health problems. The different categories associated with these problems generate inequality and discrimination. Thus:
- Women with mental health problems are more likely to experience domestic violence and their sexual and reproductive rights are more often violated.
- LGBTQ+ people suffer more physical and verbal violence.
- Ageism is also a cause of discrimination, especially among children and young people (they have detected malpractice in the health field) and among the elderly population (situations of violence in the family nucleus, institutional neglect, malpractice…).
- Other sources of discrimination include racism and xenophobia , aporophobia (for socioeconomic reasons) and ableism.
Some of the fundamental rights that enable a person to build an independent life project, so necessary for their recovery, are the right to education, work, and occupation . The report also notes that violations of these rights have occurred in people with mental health problems.
The report also points out that, although the law reforming civil and procedural legislation regarding support for the exercise of legal capacity of persons with disabilities (State Law 8/2021 of June 2) is an important step forward in guaranteeing the rights of these persons, contradictory situations still arise, such as in the review of judgments modifying legal capacity, and in this sense, it considers the figure of the judicial facilitator indispensable.
Institutional violence: involuntary admissions and coercive measures
During 2022, they identified 33 cases of discrimination through institutional violence in the form of involuntary hospital admission , in which there was physical and mechanical restraint, forced mediation and informal coercion .
In this regard, while acknowledging the need to address the institutional violence that sometimes occurs in contexts such as prisons, they also highlight various best practices for eliminating coercive measures. One such example is the Zero Restraint Program (an adaptation of Libera Care) at Sant Joan de Déu.
The future of care lies in abandoning restrictive measures
The challenge of underreporting
The cases of discrimination and rights violations identified by the Federació Salut Mental Catalunya (Catalan Mental Health Federation) are far fewer than the actual number in Catalonia. The report identifies underreporting as one of the challenges that must be addressed in defending and guaranteeing the rights of people with mental health problems. This underreporting may be due to factors such as the normalization of discrimination, lack of trust in the system, fear of the consequences of reporting, denial, shame, or even limited access to reporting procedures or law enforcement agencies, among others.
Thus, the report concludes that, despite the great progress made in defending the rights of people with mental health problems, it is still necessary to continue advancing in the incorporation of the principles of the New York Convention in all areas of mental health.
Along these lines, the World Health Organization (WHO) has developed Quality Rights , training materials aimed at improving the quality of care and support provided in mental health, healthcare, and social services, promoting human rights and the recovery model. Knowing our rights is the first step to exercising them and demanding that they be guaranteed.
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