Ministry set to reform Mental Health Act |06 October 2015
Most of us would be inclined to believe that the rights of mentally disabled people are guaranteed by the Constitution of the Republic of Seychelles and by the National Mental Health Policy and consequently observed by those responsible for applying them.
However, the answer to some simple questions shows that this is not really the case. For example, is their right to vote, own property or simply make a decision always observed? Or, their decision is rather taken by a next of kin?
Frequently, we also hear of mentally disabled being held against their will, tied to their bed, handcuffed and given other inhuman treatments. And sadly, those practices have become part of our culture as society in general has been made to accept them as a way of “controlling” persons suffering from mental impairment.
Are those forms of “control” acceptable? As stated by Dr Susan Fock-Tave of the Seychelles Hospital, the answer is rather ‘no’, as they on the contrary represent a form of abuse and violation of those persons’ rights.
“While the Constitution makes provision for the protection of mentally disabled persons, human rights violations usually occur,” she stated.
This is why the Ministry of Health has decided to review the Seychelles Mental Health Act which was enacted in 2006 and the National Mental Health Policy and align them with the United Nations (UN) Convention on the Rights of Persons with Disabilities, the gold standard against which modern health legislation is measured. Work on the review started in November 2014.
Dr Fock-Tave was speaking during a forum held at the Seychelles Hospital last week to present the review’s preliminary findings. Consulted by the Ministry of Health on the reform project, psychiatric Soumitra Pathare from the Indian Centre for Mental Health Law and Policy goes even further by stating that “Seychelles’ laws are problematic as they are outdated and usually open to interpretation”.
“The legislation has not protected people with mental illness and has rather taken rights away from them. Instead of being a protector, the law has become an aggressor,” he said.
To illustrate his reflections, he cited for example Article 12 Section 50 (2) of the Act which permits a mentally disabled to be detained in a prison even if the person has not committed any crime.
He added that as the law does not limit the detention period, the individual can be detained indefinitely and that moreover, he or she has no right to justice. This is because according to him, in the case of someone with mental impairment the judge is the psychiatrist or consultant in charge.
Dr Pathare goes on to insist that the word “detention” is a legal term which must be applied in criminal and not health cases.
“All of these are abuses of a person’s basic human rights,” he said, adding that “the laws and the language must change”. In this context, he highlighted the frequent use of the word “may” which he says “does not give you a right”.
The consultant psychiatric stressed that added to the poor legislation which causes stigma, the general mentality must also change to give people with physical impairment the opportunity to contribute in society.
“When you see somebody in a wheelchair, his or her disability is not that he or she cannot walk. It is the fact that he or she does not have access to all buildings. So finally it is not his or her disability, it is our own disability as we need to provide them better service delivery,” he insisted.
“The National Mental Health Policy must also be reviewed as the rights are not clearly defined and contradict with the Constitution. As there should be nothing about us without us, the patients concerned must also be consulted as part of the review project,” Dr Pathari concluded.
Bella Anderson, principal policy analyst in the Ministry of Health, commented that physical disability is both a health and social challenge which can affect everybody, irrespective of origin, age, sex or social status.
She added that both the public service and private sector are affected due to resulting reduced professional performance.
“No one should violate the rights of a person living with mental disorder. This is why proper legislation is needed. The present Act is not being fully implemented. The reform will bring it in line with the UN Convention on the Rights of Persons Living with Disabilities, which Seychelles ratified in 2009. It is timely, at a time when the Ministry of Health is working on a new Health Policy,” she said.
Mrs Henderson however insisted that good mental health does not start in hospitals or in treatment rooms, but in the community.
According to the World Health Organisation (WHO), one of four persons suffer from mental disorder at one point in their lives and about 500 million people are currently affected worldwide. The medical conditions include depression, schizophrenia, epilepsy, alcohol or drug disorder and the want to commit suicide. While they are predicted to be the first cause of illnesses in the near future, in many countries mental health is not on par with physical health, resulting in lack of access to medical care or total absence of any form of care. If in most countries the laws are believed to be outdated, some do not even have a relevant piece of legislature.