Mental Health and Prisons: A User/Survivor Perspective and Why it is Needed

In the CRPD negotiations, the World Network of Users and Survivors of Psychiatry (WNUSP) played a role both as experts in the subject matter and as a politically representative body accountable to its constituency. WNUSP is the member organization of the International Disability Alliance (IDA) that represents users and survivors of psychiatry, defined in our statutes as self-identified persons who have experienced madness and/or mental health problems, or who have used or survived mental health services. WNUSP has a global democratic structure with a board elected by the membership and key policies also decided by the membership, which reaffirmed our advocacy on the CRPD last year via the Kampala Declaration adopted at our 3rd General Assembly.

WNUSP includes users and survivors of psychiatry who have also experienced the prison system, and we consider any issues pertaining to users and survivors of psychiatry to be within our representative mandate. In developing positions on the prison system, the WNUSP board consults in particular with our members who have had this experience.

WNUSP agrees with the position of OHCHR that the insanity defense should be abolished, and should be replaced with measures that do not discriminate based on disability. Various possibilities exist to ensure fairness and take account of circumstances in the commission of the crime that relate to disability, while not treating psychosocial disability as an excuse for crime or a condition that puts a person beyond the reach of the law. We believe that accepting responsibility is an important part of legal capacity and full membership in society, and we embrace the need to make substantial changes to the prison system including consideration of its abolition. Prisons, like psychiatric institutions, are inherently traumatizing and degrading, and justice is unfairly and harshly administered; torture and ill-treatment persist despite the international prohibition.

CRPD Article 14 paragraph 2 needs to be the starting point for addressing the situation of people with psychosocial disabilities deprived of liberty in prisons. People with psychosocial disabilities are entitled to the same guarantees under international law as other persons, including the right to be considered innocent until proven guilty following a fair trial in a court of law. “Security measures” that remove people with psychosocial disabilities from ordinary court proceedings and instead hold hearings on whether the person is “dangerous” violate this principle of non-discrimination. People with psychosocial disabilities are also entitled to reasonable accommodation in the prison system and to be treated in compliance with the CRPD. While mental health services, peer support and other services should be made available to people who want to use them, forced or coerced treatment violates the CRPD and may constitute torture or ill-treatment (according to the UN Special Rapporteur on Torture); freedom from forced treatment applies to everyone including prisoners. Trauma-informed approaches within the penal system have proven useful, given that it is common for a high proportion of prisoners to be survivors of trauma. A trauma-informed approach helps people to heal from past abuses, while avoiding practices that cause re-traumatization.

WNUSP welcomes the interest by many organizations in the experiences and issues facing people with psychosocial disabilities in prison and looks forward to a conversation in which we, and our experts with prison experience, are invited to contribute and reflect the perspective of this constituency without whom no proper policies can be adopted.

November 2010