søndag 28. juli 2013

The Emperor’s New Human Rights

- on CRPD and forced psychiatric treatment in Norway

(English translation)

For people with serious mental problems, the same juridical rights do not apply as to the majority of the population.  The Norwegian mental health service law overruns some of the most basic human rights, like freedom from torture, inhumane and degrading treatment and potentially the right to life. Convention on the Rights of Persons with Disabilities (CRPD) was recently ratified in Norway; this convention is meant to assure non-discrimination of the human rights of people with disabilities, which includes people with mental health problems (4).
Forced psychiatric treatment has been defined as torture by UN’s torture committee, which asks for it to be banned (1). But this request has far from been taken consequences of yet. Even if many users have absolutely no experience with forced treatment helping them; on the contrary reporting about damage and re-/traumatisation as outcomes, this practice still gets to continue with referance to the law. Even if other users may say they were helped by forced treatment, the mental health service law is in itself discriminating and does not function protective for the group as a whole. I ask that this issue is taken seriously – now.

Most people exposed to psychiatric force in Norway are neither of danger to themselves or others – they are on force through the so called `treatment criteria`. This criteria allows for a doctor to make the assumption that force/ forced drugging is necessary so that the person in distress will not get "worse", or that the outlooks for recovery will be reduced if force is not applied. The recovery rates for people with psychosis/schizophrenia have shown to be much higher though with treatment alternatives like Open Dialogue in Finland, where only 1/3 were on antipsychotics and where the approaches where humane and individually flexible(2). There is a study recently published with results saying that the long term recovery rate for people with psychosis doubled with reduction or discontinuation of antipsychotics (3). 

In my opinion, antipsychotics must only be given on a voluntary basis and with very well informed consent. The doctors should be aware of the problems with unethics and publication bias within drug research and inform the person considering taking meds that it is usually only the studies with best results that are published. All kinds of side effects should be communicated, lethal ones included. It is well known that antipsychotics can cause suicide through side effects like akathisia and intense depression.  Diabetes and cardiac disease are other types of side effects that also can cause death. The brain damage tardive dyskinesia is an example of other very serious side effects of antipsychotic medication. Forced drugging with antipsychotics is an extremely invasive and personality changing treatment method. One can not predict who with psychosis/schizophrenia will actually have a positive treatment outcome on antipsychotics; according to newer research, many would have increased chances of recovery without. When the drugs then are given with force based on a traditional, general assumption about the "necessity" of APs for anyone with psychosis, one can easily imagine that those ending up with more harm than benefit from the treatment will be a significant number.

The protesting against forced psychiatric drugging is an international phenomenon. Who in Norway listen to these protests? Norway can be said to have a self image of being a human rights oriented country, which in many ways is the reality. But this societal habit belief is at the same time difficult to relate to when one has experienced that these rights did not apply when one was vulnerable and in need of extra protection. In my view, every day that passes with the present mental health service law is expressing a distain for the human rights of some of the most vulnerable in our society. I ask that there will very soon be taken juridical consequences of the Norwegian ratification of CRPD.

Anne Grethe Teien,

2)            http://www.tandfonline.com/doi/abs/10.1080/17522439.2011.595819#.Ub7pUqc4XIU
3)            http://www.madinamerica.com/2013/07/antipsychotic-reductiondiscontinuation-produces-higher-long-term-recovery/
4)     http://www.ohchr.org/EN/HRBodies/CRPD/Pages/ConventionRightsPersonsWithDisabilities.aspx

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