Human rights law in the field of mental health: a critical review.

The 'centrepiece' of international human rights law in the field of mental health is often said to be the United Nations Principles for the Protection of Persons with Mental Illness of 1991. Some observers appreciate the symbolic importance of these principles in providing visibility to the needs of the mentally ill, in stressing the right of access to adequate mental health care and in establishing the principle equivalence between psychiatry and the rest of medicine. However, the Principles appear basically flawed in several respects: (1) they do no have the status of a formal international treaty; (2) States are not required to adopt the Principles as 'minimum standards' for the protection of mentally ill persons; (3) in some respects, notably on the issue of consent to treatment, the Principles remove patients' rights rather than reinforce them; (4) the Principles do not provide for redress nor for any form of monitoring, inspection or supervision by an independent international body. Thus, it appears that even at an international level the deep-seated societal ambivalence towards the mentally ill has taken root and that so called 'human rights' principles have little material effect on the lives of psychiatric patients and create double standards in the exercise of choice.