Human Rights Are Fundamental to Good Mental Health Services

Thankfully most people never have to worry about their human rights. For many, they can seem fairly distant: something for lawyers and politicians to worry about, with little impact on our own everyday lives...

Thankfully most people never have to worry about their human rights. For many, they can seem fairly distant: something for lawyers and politicians to worry about, with little impact on our own everyday lives. When we do hear about human rights in the media it's usually via a story that links them with supposedly 'undeserving' groups or used as a proxy for anti-European views. But this picture hides the uncomfortable truth that people in the UK do still have their rights abused.

People with mental health problems often fall through the human rights safety net. The mental health system has extensive powers to detain people, to deprive them of their liberty, to restrain them and to force people to take life-changing drugs. To ensure people's rights are not violated, these powers must be subject to rigorous checks and balances. Worryingly, however, we know this is not always the case.

Public debate about human rights, equality and social justice issues is often based on misperceptions and doesn't always focus on the very real abuses that still happen. It also makes it difficult for people to assert their own rights, particularly when they are in a vulnerable situation: disorientated, frightened and alone, as people experiencing a mental health crisis often are.

Last year, Mind launched a campaign to end dangerous face-down restraint practices in mental health hospitals, and for better training and regulation of all types of physical restraint of people detained under the Mental Health Act 1983. Through a Freedom of Information Request, we had found that the use of physical restraint in mental health hospitals varies widely from one NHS mental health trust to another, meaning that many people are in all likelihood being restrained too quickly, despite this response supposedly being a last resort.

Less than a year on, the Department of Health today launches new guidance on the use of restraint, which aims to dramatically reduce the use of all forms of restraint and to end the deliberate use of face-down restraint. It is fantastic to see that central to the key principles of the guidance is a human rights-based approach to managing behaviour that may be challenging. The guidance emphasises the need to involve people in planning their own care and to empower them to understand their rights are and to realise them.

But what can we do when someone isn't able to participate in their own care? What if someone lacks capacity to make decisions about their care? When this happens sometimes the state has to assist in making decisions on their behalf?

A landmark Supreme Court ruling last month (P v Cheshire West and Chester Council and P and Q v Surrey County Council) should help prevent thousands of people with mental health problems and learning disabilities from having their basic rights violated when deprived of their liberty. People can be deprived of their liberty under the Mental Capacity Act but, if so, it must be done with special safeguards in place to make sure it is the least restrictive option possible and done in their best interests.

The Supreme Court judgment clarifies how to determine whether care arrangements for a person who lacks capacity to decide where to live amount to a 'deprivation of liberty'. The acid test is whether the person is free to leave and whether they are subject to continuous supervision.

Previous judgments had been clouded by other issues, such as whether or not the person raised any objection to their circumstances or whether they would have had much freedom in any case, given their circumstances. The judgment rightly recognises that these things are irrelevant and she puts human rights at the heart of her reasoning - we all have the same basic rights as each other, regardless of individual circumstances. Human rights are universal.

It's frightening that, in this day and age, this basic principle can be forgotten

If you found yourself sectioned or restrained or deprived of your liberty on the grounds of capacity, you'd want your human rights to be at the forefront of the minds of people who make those difficult decisions. But for many people, the idea of a human right has become distorted by high profile cases in the media. Organisations that should be proud to talk about human rights are instead scared of a backlash. When we make 'rights' a dirty word, we weaken their ability to protect any of us at our most vulnerable.

Better awareness of the true value of human rights gives people the confidence to challenge abuse when it happens and can prevent abuse happening in the first place. We need to see human rights for what they are: simple, straightforward values that embody what everyone wants to see from our public services. Dignity, respect, fairness, justice, equality, empowerment, autonomy - these are fundamental principles that should be the yardstick for measuring success or failure across our public services. These are the things that every one of us has a right to, no matter what our circumstances.

Mind is a member of the Equally Ours campaign to raise awareness of human rights.