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 blazej.kmieciak@umed.lodz.pl

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?

Psychiatric Patients Ombudsperson 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 Convention on Human Rights and Biomedicine 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