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Abuse of people with mental disabilities:
Problems and hopes
Dr Błażej Kmieciak
(Doctor of Sociology in Law)
Department of Medical Law,
Medical University of Lodz
[email protected]
Problems and Questions
• Can mental disorders be called
“a disability”?
• Are people with mental
disabilities excluded or
marginalized from the society?
• What are the ways in which they
experience exclusion or abuse?
• How to combat the negative
trends?
• How to stand up for the rights of
people with mental disabilities?
Mental disability?
• When we think of people with
disability:
• 63% - mobility problems
• 43% - visual impairment
• 20% - moving in wheelchairs
• 18% - paralyzed
• 18% - hearing impairment
• 14% - intellectual disabilities
• Mental disability???
(Prof. A. Ostrowska)
Social exclusion
The number of days off due to mental disorders
has increased in Poland by 70% from 2010 to
2016, that is incomparable to any other health
problems. Taking into account the fear of
stigma in the workplace, actual scale of the
problem is probably much higher.
• Only 2% of people with schizophrenia is
economically active;
• 75% of this group of patients gets a
permanent disability pension.
Social exclusion
• Media language:
- Campaign “Stop road lunatics”
- Newspaper headlines: “crazy”,
“madman”, “mad”
- Linking mental illness with
aggression, crime
• Politicians’ language: “crazy”,
“insane”, “lunatic”.
• Psychiatric tests designed for
political candidates are proposed.
Psychiatric ward
What does the internet show?
Hospital ward
What does the internet show?
Positive action
Psychiatric Patients Ombudsperson
• In January 2006, the first 10 Psychiatric Patients
Ombudspersons were established;
• In 2017, about 40 Ombudspersons are employed in
Poland;
• From 2006 to 2008 about 30 thousand complaints were
reported;
• Spokespersons are employees of the Office of the Patient
Ombudsperson acting under the Act on Patients' Rights and
the Ombudsperson for Patients' Rights.
The task of the Ombudsperson
• Assisting in the investigation of the patients’ rights in terms of their
application;
• Admission, residence, treatment and discharge from hospital;
• Consideration of: complaints, requests, questions;
• Co-operation with the family and the patient’s guardian;
• Information and educational activities.
The Ombudsperson's own initiative - assessment of observance of the
rights of patients:
1) Admitted to a psychiatric hospital without consent;
2) Subject to direct coercion;
3) Treated without consent;
4) Staying in a psychiatric hospital under a court decision on the
application of a preventive measure.
The Ombudsperson and his/her role
• Lawyer: provides legal advice,
explains the content of the
provisions, consults with the judge;
• Mediator: attempts to explore the
causes of the conflict in order to
resolve the conflict. Should be
impartial;
• Controller: checks the level of
respect for the rights of the patient;
• Therapist: intervenes in the situation
of crisis, actively listens to the
patient.
Law basics
Art. 10b-10d Mental Health Protection Act
Convention for the Protection of Human Rights and Fundamental Freedoms
• ARTICLE 3 Prohibition of torture
• ARTICLE 5 Right to liberty and security
• ARTICLE 6 Right to a fair trial
• ARTICLE 8 Right to respect for private and family life
• ARTICLE 13 Right to an effective remedy
• ARTICLE 14 Prohibition of discrimination
Convention on Human Rights and Biomedicine
• Article 7 Protection of persons who have a mental disorder:
Subject to protective conditions prescribed by law, including supervisory,
control and appeal procedures, a person who has a mental disorder of a
serious nature may be subjected, without his or her consent, to an
intervention aimed at treating his or her mental disorder only where, without
such treatment, serious harm is likely to result to his or her health.
Self-advocacy
• Spokesperson in your own
case;
• Developing the ability to
speak-up for your rights;
• Training of social skills: to
stand up for your rights,
saying “no”, making
decisions, expressing
opinions;
• Taking action alone or access
to an assistant;
• The law has a unique value.
Thank you very much
The law is working in the psyche of every
human being.
Prof. L. Petrazycki
After many years of work, a psychiatrist is
convinced that his patients are in some
sense better and deeper than those who
are not considered “the other”. The
following thought was expressed by (...)
one of the nurses: “To hospital are
admitted those who feel and see more.
Therefore, they suffer more.”
Prof. A. Kępiński