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The mental health paradigm

15 December 2023 / Laura Davidson
Issue: 8053 / Categories: Features , Mental health
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Laura Davidson asks if new UN guidance could topple compulsory detention & enforced medical treatment
  • Covers guidance issued by the World Health Organisation and the UN Office of the High Commissioner for Human Rights.
  • Suggests it may help end practices of coercion and compulsory treatment, and could have a stronger impact than international human rights law.

A quarter of a century ago, the UK ratified the UN Convention on the Rights of Persons with Disabilities (CRPD). It prohibits discrimination, including against those with ‘mental… [or] intellectual impairments’ (Art 1). Despite being binding, global compliance remains patchy. However, all psychiatric coercion—compulsory hospitalisation, physical and chemical restraint, seclusion and segregation—is discriminatory and hence unlawful.

The European Court of Human Rights deems psychiatric force lawful if necessary and proportionate, the least restrictive option and a last resort. The UK’s 40-year-old Mental Health Act 1983 (MHA 1983) permits coercion to protect someone’s health or safety, or others (s 2(2) and s 3(2)). Restraint (which may cause death) and seclusion (a recognised form of torture) can

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