How right is right-based mental health law?

Perceptions regarding the Indian Mental Healthcare Act 2017 among psychiatrists: Review and critical appraisal in the light of CRPD guidelines

“…Section 4 of the IMHCA 2017 asserts that every individual, including PwMI, is presumed to possess the capacity to make decisions about their mental healthcare or treatment provided they can understand relevant information, appreciate foreseeable consequences and communicate their decisions. However, the vagueness of this mental health capacity definition, without explicit mention of legal capacity, raises concerns (Jagadish et al, 2019;Kumar et al, 2019aKumar et al, , 2019bRaveesh et al, 2019). Without welldefined criteria to assess mental capacity and the absence of legal capacity, as enshrined in Article 12 of the CRPD, coercive treatments involving nominated representatives could become prevalent.…”

“…According to these experts, this ambiguity commences with the act’s definition of mental illness (Duffy and Kelly, 2019a; Duffy et al, 2019a; Math et al, 2019b). The act defines mental illness as “a substantial disorder of thinking, mood, perception, orientation or memory that grossly impairs judgment, behavior, capacity to recognize reality or ability to meet the ordinary demands of life, mental conditions associated with the abuse of alcohol and drugs, but does not include mental retardation which is a condition of arrested or incomplete development of mind of a person, specially characterized by subnormality of intelligence.” This definition, however, omits certain psychiatric conditions that may not lead to significant cognitive alteration but still cause considerable distress and dysfunction, such as common mental disorders or harmful substance use (Rugkåsa and Canvin, 2017; Mohan and Math, 2019; Raveesh et al, 2019). Furthermore, neurodevelopmental disorders, which often manifest with psychiatric symptoms, are not encompassed by this definition, possibly leading to confusion and treatment dilemmas (Bijal et al, 2019; Sharma and Kommu, 2019).…”

“…Concerns were raised by certain psychiatrists that certain provisions within the act, particularly those allowing for nominated representatives beyond immediate family, might inadvertently foster an incorrect perception that family members are the primary violators of the human rights of those with mental health conditions. This, in turn, could potentially disrupt family dynamics (Ali et al, 2019; Bijal et al, 2019; Duffy and Kelly, 2019a; Jagadish et al, 2019; Math et al, 2019b; Pavitra et al, 2019; Raveesh et al, 2019). Some psychiatrists also expressed the view that the provision of advance directives could lead to increased treatment costs, thereby placing an additional financial burden on families (Jagadish et al, 2019).…”

Mental health services in Hong Kong: development of community-based inclusive development practice faced with the cultural barriers

“…The society must change to embrace human diversity and enable the participation of all members of the community. A rights-based approach to disability is defined as the application of international human rights standards to empower people with disability (Raveesh et al , 2019). It supports the realisation of non-discrimination, social justice, participation, and accountability in a community.…”

“…The social model aims to better organise the systems in a society to accommodate human diversity and enable participation. In a social model with a rights-based focus, people with disabilities are framed as rights holders whereas the government and other service providers are framed as duty bearers (Raveesh et al , 2019). Systems and institutions are therefore responsible for protecting, respecting and observing the rights of people with disability.…”