"Protecting mental health clients' dignity - the importance of legal control"
Users of mental health services as well as other people have the right to express their needs, influence their treatment and be regarded as equal participants in society.
The gap between public values and clients' experiences has been noted by the Council of Europe, as well as by the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment, which monitors the protection of human rights in Europe.
Factors which may influence attitude and treatment of mental health clients:
• Definitions of otherness
In several health service settings, a culture has developed which dictates that mental health clients may be treated differently from somatic clients, and ethical principles may be applied differently.
• Reductionist explanations
The way contextual factors such as economy and social situation influence mental illness is often overlooked. Causes outside the individual may then be localized inside the person.
• Broad professional credentials
Professionals traditionally take action on behalf of these clients, while their subjective needs and opinions are overlooked.
The analysis of clients' narratives verifies the existence of a gap between human rights' aims and clients' experiences in several settings. There is a lack of safeguards against infringement. Infringement has substantial consequences in both the short and long term, and it becomes embedded in people's minds and influences the quality of their lives. Hundreds of reflective, detailed and consistent stories told by clients about situations in which they were not listened to or granted credibility provide documented evidence of a mental health service system marked by a lack of responsiveness towards people who are more than able to express themselves.
Mental health clients experience infringements that cannot be explained without reference to their status as clients in a system which, based on judgments from medical experts, has a legitimate right to ignore clients' voices as well as their fundamental human rights.
To bring about changes, recommendations and practices should be harmonized with the new UN Convention on the Rights of Persons with Disabilities.