Liberty: human rights and mental health

In this paper, Lord Phillips reflects on the present state of the law relating to mental health; he considers the place of the common law doctrine of necessity as the basis for the detention of patients; he reviews a number of issues arising from the jurisprudence of the European Court of Human Rights in Strasbourg and a number of recent decisions of the Court of Appeal. Finally, he considers the prospects for change in the law foreshadowed in the Government's White Paper on the Reform of Mental Health Law (2000).     

Psychological models of mental disorder, human rights, and compulsory mental health care in the community

Recent amendments to the 1983 Mental Health Act in the UK (Mental Health Act 2007) include the controversial provision for: “supervised treatment in the community for suitable patients following an initial period of detention and treatment in hospital”. This provision is widespread, and more formal, in other English-speaking jurisdictions. Reviews of the international literature, human rights considerations and the perspective of psychological approaches to mental health care suggest that proposed ‘supervised community treatment orders’ are valuable, lawful, and compatible with the European Convention on Human Rights if certain specific conditions are met. Provisions for ‘supervised community treatment orders’ in the UK should be supported, but with the provisos that: the powers of the Mental Health Act are limited as in Scotland, to persons whose “ability to make decisions about the provision of [care] is significantly impaired”, that each order is time-limited and subject to review by a properly constituted Tribunal, and that the use of such orders should represent a benefit to people in terms of more appropriate treatment, or be a least restrictive alternative, or better preserve the person's private and family life.     

Facilitating corruption and human rights violations: the role of international financial institutions

The connection between corruption and the suppression of human rights has been recognized by scholars of human rights, state and state-corporate crime, non-governmental organizations, the United Nations as well as various governments. Scrutiny of governmental and/or regime corruption has been a primary focus, in relation to barriers and/or violations of human rights. Additionally, multinational companies’ complicity in corruptive policies and practices has raised concerns, in particular in the arms and natural resources sector. Glaringly absent, however, within the criminological literature are discussions of, and research on, the role of international financial institutions (IFIs) in relation to high levels of state corruption, save for the relatively little criminological research that has explored how cooperative endeavors between international financial institutions, transnational corporations, and states often result in demonstrably harmful activities as a result of structural adjustment policies. As such, it seems appropriate to consider how certain components and/or policies of IFIs facilitate rather than constrain corruptive practices by regimes, militias, paramilitaries, and transnational corporations. Such an exercise is not only important for its etiological contributions, but also to draw criminological attention to this phenomenon and because these organizations have stated a commitment to reducing state level corruption. I hope to extend the focus and insights of criminological analysis of crimes of globalization herein.     

The third way in mental health policy: negative rights, positive rights, and the Convention

Mentally disordered patients may be said to have rights in two senses: negative rights to freedom from arbitrary detention or interference with their person; and positive rights to expect a certain minimum standard of service, be that in terms of treatment as an in-patient, or as a patient in the community. The Labour government has appointed a 'scoping group' to carry out a root-and-branch review of the Mental Health Act 1983. The 1983 Act was mainly concerned with in-patient treatment. The group is to look at the scope for introducing further compulsory powers in the community, enhancing the rights of carers and relatives, and is to take account of recent British and Strasbourg case law. The primary impact of the Convention on psychiatric patients has been in relation to protection against arbitrary detention under Article 5, unsoundness of mind being one of the permitted grounds of deprivation of liberty under Article 5(1)(e). This article explores the potential impact of Convention rights in developing what Gostin referred to in the early 1980s as a 'new legalism'. The new legalism linked concern for traditional rights to due process and review by the courts or other external bodies with the 'ideology of entitlement' to adequate treatment and services. The article outlines the current policy context of mental health services and looks at the development by the European Court of Human Rights of positive Convention rights to services out of Article 5, whose purpose seems at first sight to be the protection of due process rights. It examines the relevance of Convention rights to community powers.     

Human rights violations and genocide in the Democratic Republic of the Congo

The massacres that took place in the Democratic Republic of Congo (DRC) between 1996 and 2003 have posed an interesting challenge to the global community, specifically to its more powerful members. Ironically, the Tutsi-dominated government of Rwanda enjoys international recognition and benefits based on the genocide, Rwanda suffered in 1994, but continues to deny the same benefit to Hutus as they were accused of leading a counter-genocide campaign then in the DRC. While the people of the DRC, as well as human rights activists, call for justice for all who were affected, the government of Rwanda, strongly backed by a number of powerful international powers, opposed attempts by the international community to pin charges of genocide perpetrated by its army in the DRC on it. Because of the clear negation of the genocide report by the Rwandan government, the nature of human rights, human rights violations, and genocide criteria proposed and defended by key members of the international community in relation to the mass killings in the DRC are examined.     

Detention and treatment down under: human rights and mental health laws in Australia and New Zealand

Mental health law reform in recent decades has drawn on the international human rights movement. The entering into force of the Convention on the Rights of Persons with Disabilities (CRPD) on May 3 2008 has been hailed by some as signalling a new era in relation to how domestic mental health laws should be reformed. Both Australia and New Zealand have ratified the CRPD and Australia has acceded to its Optional Protocol. New Zealand and the Australian Capital Territory and Victoria have statutory bills of rights which have an interpretive effect, but are unable to render other statutes invalid. Drawing on the results of interviews conducted with fifty-two representatives of consumer and carer organisations, lawyers, and mental health professionals across Australia and New Zealand, this paper examines the current thinking on human rights and mental health laws in these countries and outlines what changes, if any, may be brought to domestic legislation in light of the Convention.     

Mental health and human rights: the role of the law in developing a right to enjoy the highest attainable standard of mental health in Australia

Article 12(1) of the International Covenant on Economic, Social and Cultural Rights requires governments to recognise "the right of everyone to the enjoyment of the highest attainable standard of physical and mental health". However, the traditional focus of mental health laws on the treatment and detention of those with low-prevalence serious mental illnesses may have skewed resources such that the development of a right to mental health for all individuals with mental illnesses has been stymied. In Australia, a number of inquiries and reports have found that while legislation has been changed to comply with human rights principles, access to mental health care and follow-up post-hospitalisation need critical attention. This article outlines a five-year project aimed at exploring how mental health laws can help develop and support a right to enjoy the highest attainable standard of mental health.     

Assessing competency to waiveMiranda rights in defendants with mental retardation

Criminal defendants with mental retardation face special problems in the process of interrogation and confession, particularly with regard to the knowing, intelligent, and voluntary waiver ofMiranda rights. Despite this, little attention has been paid to empirical measurement of this form of competency in mentally retarded adults. The present research uses scales originally developed by Grisso (1981) to measure competency to waive such rights in juveniles. Two samples of mentally retarded adults, one in a sheltered workshop setting and the other composed of current probationers, were tested. Both samples scored substantially lower on measures ofMiranda comprehension than Grisso's samples of juveniles and adults. There were also differences between the samples that appear attributable to differential levels of criminal justice experience. It is concluded that the Grisso scales may be helpful in determining competency to waiveMiranda rights in defendants with mental retardation. In addition, the present data raise strong concerns about the ability of many such defendants to make intelligentMiranda waivers. Policy recommendations are discussed.     

Children's involvement in contested custody cases: Practices and experiences of legal and mental health professionals

The experiences and practices of family law attorneys, trial judges, and mental health professionals regarding the involvement of children in contested custody cases were investigated through a systematic and detailed survey. Results revealed that the level and manner of children's involvement was linearly related to a child's age as reported by all groups. Judicial jurisdiction was also related to whether children's wishes were sought and in what manner; specifically, Michigan judges were significantly more likely to interview children using flexible due process than Virginia judges. In addition, interview procedures used by mental health professionals and judges, such as length, making of records, and the presence of other individuals, differed significantly. The amount and complexity of children's involvement suggest that further research is needed to explore these complexities and their effects on children.