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Parliamentary Assembly of Council of Europe calls for an end to coercive practices in mental health

The Parliamentary Assembly of the Council of Europe (PACE) in Strasbourg called for an end to coercive practices in mental health through a resolution and recommendation that were unanimously adopted during its summer session on June 26,  2019.

The Assembly wants mental health systems across Europe to “be reformed to adopt a human rights-based approach which is […] respectful of medical ethics and of the human rights of the persons concerned, including of their right to health care on the basis of free and informed consent”.

The call comes after on 13 May 2019, the PACE Committee on Social Affairs, Health and Sustainable Development has urged Council of Europe member States to “immediately start to transition to the abolition of coercive practices in mental health settings”.

Autism-Europe very much welcome this new step,  as we  have been opposing the draft Additional Protocol to the Oviedo Convention – regulating forced treatment –  through the campaign “Withdraw Oviedo”., alongside many other organisations.

In her presentation, of the report “Ending coercion in mental health: the need for a human rights-based approachDutch liberal politician Reina de Bruijn-Wezeman, explained that “today, across Europe, a growing number of persons with mental health conditions, or psychosocial disabilities, are also subject to coercive measures such as involuntary placement and treatment. These persons experience overwhelmingly negative effects of coercive measures, including pain, trauma and fear.”

Ovideo Convention Amendment proposal comment

The rapporteur also talked about the historical background in the Committee of Ministers’ decision to work on an Additional Protocol to the Oviedo Convention, aimed at protecting the human rights and fundamental freedoms of people with mental disorders, with regard to the use of involuntary treatment. She said that in 2016, the Assembly opposed the drafting of this Additional Protocol that is authorising, while regulating, the use of involuntary treatment and placement. In particular, the Assembly raised concerns about the protocol’s compatibility with the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD).

The rapporteur pointed out that despite opposition from NGOs, the UN special rapporteur on the Rights of Persons with Disabilities, Council of Europe Commissioner for Human Rights, and the Parliamentary Assembly the drafting of the work on the Additional Protocol still continues. Thus perpetuating the culture of confinement that focuses and relies on coercive measures, and failing to adopt a Human Rights-based approach.


Read here the Commissioner for Human Rights Intervention

Council of Europe Commissioner for Human Rights Dunja Mijatović shared how she witnessed herself “how the lack of community-based voluntary mental healthcare services, result in even more coercion and deprivation of liberty. This causes tremendous suffering to the individuals concerned, at great cost to our societies. I do not want to belittle the positive impact that psychiatrists can have in the well-being of their patients, and mental health is a key component of well-being.”

Debate on the report “Ending coercion in mental health: the need for a human rights-based approach”

Vice-President Stella Kyriakides from Cyprus spoke from her personal experience as a clinical psychologist working for many years in mental health when treatment was only done in big isolated asylums. The admission was only by force, using the excuse of being a danger to oneself and to others.

Þórhildur Sunna Ævarsdóttir, an Icelandic social democrat, expressed that people with mental conditions are systematically and very frequently deprived of their right to exercise their rights. Coercion and mental health can constitute torture. It can constitute a violation of people’s fundamental right to bodily autonomy. And it can constitute a violation of our right to decide on our fertility. Sterilisations and forced abortions are still practiced today in Europe against people with mental conditions. This is something that needs to stop. That this this report is a step forward.

Béatrice Fresko-Rolfo, a liberal deputy from Monaco, highlighted that for decades, mental health coercion has been the subject of exciting political-philosophical debates. The debates have led to an anti-psychiatric movement. Priority must be given to the will of patients and develop a local mental health policy dominated by the need to respect consent. Providing patients with care as close as possible to their homes, with the condition of success being an increase in human and financial resources.

Maura Hopkins, an Irish conservative, added that as occupational therapist and as senator she knows that people with mental health difficulties should be supported to live in the community and to be very involved in their treatment, allowing choice, allowing autonomy and allowing consent.

Thomas Hammarberg, former Human Rights Commissioner, finds that the broad consensus shows the great importance of this issue. “This is definitely an area where the Council of Europe could play a very important role to stimulate our Member states really to be serious about protecting human rights for this group of people. The situation in reality is still not good in spite of the UNCRPD. Not all Member states have even ratified that Convention which we should ask them to do.”

After the debate, the resolution was unanimously adopted with 90 members present and voting. Then, the recommendation was adapted by all 87 members’ present and voting.