Violations of rights in mental health

Human rights are basic rights that we have simply by virtue of being human, and they are essential to enjoying a good life and to prospering. The basic principles that underpin them are fairness, respect, equality, dignity and freedom for all people. All rights are interrelated and interdependent, so that the enjoyment of one depends on the enjoyment of others, and the denial of one right negatively affects all others.

When the human rights of a person or group are not respected, we say that their rights have been violated . These violations can occur all over the world by diverse actors, from governments and organizations, to service workers or any citizen. They are often the product of inadequate practices or poorly applied policies, but sometimes they occur without being aware of it, without the intention of doing harm.

People with mental health problems and people with disabilities are more likely to experience violence, neglect or abuse.

There are population groups at greater risk of suffering discrimination, social exclusion and the violation of their rights, such as women, migrants, children, people from the LGTBIQ+ community, the elderly and people with disabilities or mental health problems. All these population groups tend to share discrimination in all areas of life (at work, school, in the family, etc.), which is due to complex factors that interact with each other, but also to power imbalances between different groups.

Understanding human rights in the context of mental health

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Thus, people with mental health problems and people with disabilities are more likely to suffer violence, neglect or abuse, and among the discriminations they usually encounter are, for example, restrictions on the exercise of their right to vote and the right to run for government office, with the consequent loss of influence in the community and the difficulty of defending themselves or defending their collective interests. They may also experience restrictions in access to social services and health care; sometimes they receive lower quality treatment or their health problems are belittled , or they may even be excluded from aid operations in the context of natural disasters and violent events, as denounced by the World Health Organization (WHO).

Not informing a person about the treatment being administered, its side effects and the existing alternatives is a violation of rights.

The lack of educational and employment opportunities has a strong impact on a person's autonomy. Without a good education and training it is much more difficult for them to have a future job and be independent, and without the possibility of earning an income it is easier to find themselves in situations of poverty or homelessness, and more difficult to get out of them.

All of these factors and difficulties combine to cause people with mental health problems to have higher rates of illness and premature death .

Situations in which the rights of people with mental health problems are violated

Some specific situations that involve a violation of the rights of people with mental health problems are:

• Sterilization, contraception or miscarriage.
• The loss of custody of children simply because they have a mental disorder.
• Explicitly advising the person against motherhood or fatherhood because they have a mental health problem.
• Committing the person to residential centers against their will, or restricting their exits.
• Receiving discriminatory treatment at work, for example, relegating the person with a mental health problem to doing tasks below their training and qualifications, firing a worker when they explain their disorder, excluding them from selection processes, not adapting the workplace to their needs (making it difficult to access and maintain a job), etc.
• Deny access to financial products (credits and mortgages), to insurance.
• Denying or making it difficult for a person to make a formal claim or complaint, for example, in the service where they have been treated.
• Restrict communication with the outside world in intensive care services, for example, by taking away the mobile phone, or requiring that calls be made in spaces with little privacy (corridors, in front of service professionals, etc.).
• Economic violence and coercion (i.e., controlling a person's resources to force them to act against their will).
• Failure to inform about the treatment being administered, its side effects and existing alternatives.
• Giving a person medication without their consent (for example, hidden in food).
• Inducing a person to believe that their actions will have negative consequences or that action will be taken against them or that they will be denied certain things (for example, access to food, newspapers or television) if they do not accept treatment.

QualityRights: the definitive push towards change

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In addition, there are healthcare practices that can also constitute rights violations and that the United Nations considers may constitute torture and ill-treatment. Some of these measures are:

• Involuntary treatment.
• Unjustified involuntary admission.
• Isolation and mechanical containment.
• Forced medication and overmedication.
• Electroconvulsive therapy, if applied without informed consent (the person must have been previously informed of its risks and have been able to assess them).
• The abuse of incapacity measures (guardians and other forms of substitute decision-making).

The person's situation can be aggravated because rights violations are usually not reported , often because the person is not aware of this violation or, if they are, does not know how to make a claim or complaint. And sometimes it is not easy, because there may be obstacles to accessing the complaint mechanisms, because they consider that the person with mental health problems is not credible or because the person is afraid of possible reprisals (the complaint may be perceived as a manifestation of their symptoms or an attack on the service or the professionals who work there). In addition, there are people who do not want to relive the violation because of the suffering that doing so entails.

Therefore, it is important that everyone (professionals, people receiving care, family members and citizens) learn to identify situations that violate the rights of people with mental health problems and act on them.