Dr Justin Barry-walsh1
1CCDHB, Wellington, New Zealand
The United Nations Convention of the Rights of Peoples with Disabilities (UNCRPD) has become an important document, given the number of countries that are now signatories. Both the convention itself and interpretation of the convention provided by the UN Monitoring committee have much to say about the rights of those with mental health issues, including and perhaps especially in their contact with mental health services and the law. At first blush many practices currently common place in forensic psychiatry would seem to be in breach of the convention. This would include coercive treatment, use of restraint and seclusion, exculpatory mental state defences and fitness to stand trial. However, neither the convention nor the interpretation of it by the committee is without its critics who have pointed to issues including logical inconsistencies and contradictions. I take a deliberately clinical approach to these issues as a forensic psychiatrist. In doing so, I hope to highlight some of the problems and the challenges the UNCRPD creates and discuss how to respond. This will include consideration of the ultimate issue – what weight should we give to the convention and the interpretation of it – in other words how bothered should we be?
I am a consultant forensic psychiatrist based in Wellington New Zealand. My work interests include fixated threat assessment and avoidance of being ambushed by conventions my country has signed up to, but hasn’t bothered to tell me about.