Next week Ireland will be examined by the UN Committee on Economic, Social and Cultural Rights (CESCR) – and the impact of austerity measures on the Irish public over the last several years will be scrutinised. In this post, I highlight some key issues from a disability and mental health perspective which might be addressed by the Committee, based on the concerns outlined by various civil society groups.
The List of Issues developed by CESCR has already asked the Irish Government for clarification on a number of key issues that impact on the enjoyment of socio-economic rights by people with disabilities and those with mental health issues. This included questions about the right to employment and the availability of supported employment for people with disabilities, the use of measures to monitor and enforce compliance with regulations governing residential centres for people with disabilities (particularly relevant in light of Aras Attracta and other similar revelations) and the implementation of the Education for Persons with Special Educational Needs Act 2004. From a mental health perspective, specific questions have been asked of Ireland on the shortage of capacity in mental health-care facilities for children, the impact of closure plans and the availability and development of community-based mental health-care services, and services for older persons and persons with disabilities.
While Ireland’s response to the List of Issues provided extensive information on efforts to improve employment and education opportunities for people with disabilities and mental health issues – several issues raised by the Committee reflect broader concerns from civil society and could be addressed in further detail in the dialogue next week. On the issue of residential centres for people with disabilities – monitoring is clearly an urgent task – but perhaps the more pertinent question would be what efforts are being made to ensure that people with disabilities are not segregated into separate residential facilities in the first place but rather given adequate housing, fully integrated in the community, with the supports required to participate in society on an equal basis with non-disabled citizens. This issue was raised in a joint civil society report, authored by the Free Legal Advice Centres, which drew on contributions from 78 civil society organisations and individuals. It was also raised by Jim Winters from Inclusion Ireland in a guest post on thejournal.ie.
In the mental health context, CESCR has an opportunity to question the continued operation of involuntary psychiatric treatment under the Mental Health Act in Ireland. Civil society shadow reports such as those submitted by Tallaght Trialogue and Mindfreedom Ireland address this issue and particularly focus on the continued use of non-consensual electroconvulsive therapy, which can be authorised in Ireland where a patient is ‘unable or unwilling’ to give consent if the treatment is approved by two consultant psychiatrists. This approach stands in stark contrast to CESCR’s General Comment 14 on the right to health which states that this right includes “the right to control one’s health and body, … and the right to be free from interference, such as the right to be free from torture, non-consensual medical treatment and experimentation.”
Following on from the approach taken by the UN Human Rights Committee which examined Ireland’s record on civil and political rights last year, a holistic approach should be taken to conceptualise how social, economic and cultural rights are understood in light of the lived experience of people with disabilities and mental health issues. In so doing, CESCR can take into account the human rights norms established in the UN Convention on the Rights of Persons with Disabilities, even though Ireland is not yet a State Party to that Convention. Indeed, this may ultimately form part of CESCR’s recommendations to Ireland, that in order to cement its commitment to fully achieve the social, economic and cultural rights of people with disabilities and mental health issues, Ireland should ratify the CRPD without further delay.