Happy with the CRPD Committee

Today was a great day. The CRPD Committee is really my favourite UN committee. I feel so empowered :)

Today we were at the UN OHCHR at Palais Wilson again. At 10 AM the session on Costa Rica started. I was really curious to see if the testimony of a person with lived experience of forced psychiatric treatment in Costa Rica that I had sent would raise any questions. So I listened carefully.
First the delegation representing the government of Costa Rica presented their answers to the CRPD Committees questions. They spoke about many reforms at all levels, such as: they were striving to make a mechanism without guardianship, because such a system is unacceptable today, and support services need to be put in place. But it’s not all there yet, and they are still working on it. And that argument lasted throughout the conversation: working on it, but not there yet. Also in terms of policy implementation and monitoring and access to justice: they lack the team, the means and the resources to do the job, and they are reforming to make it stronger, so they are working on it, but not there yet. But still I heard quite some good language (CRPD-compliant). Yesterday I had been very sceptical about the nice words, because I was informed by the NGOs and another contact person, about the shortcomings and human rights violations towards persons with disabilities in Costa Rica . However, today, Costa Rica really showed respect to the CRPD Committee’s questions and recommendations, and emphasized that they would study the Concluding Observations, as a good exercise of useful self-critique for improvement, and they assured that Costa Rica would implement the recommendations. “The CRPD is our moral authority, and the Concluding Observations will help to raise awareness”. I was impressed by such an open attitude. Later it was once again stressed that Costa Rica had had a role in the drafting process of the CRPD (which was confirmed by the Committee members), and they seemed to take the CRPD very serious.

After the delegation of Costa Rica had spoken, the CRPD Committee asked their third and last set of critical questions. All of us (WNUSP) were happy to hear CRPD Committee member Edah Maina raise a very firm question about persons in psychiatric institutions in Costa Rica. The state report says that it is unknown how many institutions there are, or what the number of persons in institutions is. And also not the reasons why they are there, and the “lack of family support” should not be a reason. Lack of family support is not a reason to detain persons in institutions against their will, since they are able to live in the community. The current shift from the medical to a rights-based model demands a reform on legal capacity, and also includes ending forced commitment in psychiatry, and to abolish all forms of compulsory treatment, violence, and protecting the autonomy and integrity of persons with mental en psychosocial disabilities. The reform should not be based on the WHO-principles, so do not fall back into that, as these run contrary to the CRPD, the CAT and the recommendations of the Special Rapporteur on Torture.
That was a beautiful question, which moved us all. A bit later also CRPD Committee member Theresia Degener raised an extra question “After she had just received some disturbing information on institutions for persons with psychosocial disabilities, she would like to know whether there is a national mechanism to prevent torture (NPM), and whether organizations of persons with disabilities (DPOs) are involved”. Then also CRPD Committee member Silvia Quan-Chang, who is also the committee’s rapporteur on Costa Rica, expressed her concerns about the situation in psychiatric hospitals and clinics, after receiving a testimony describing a horrendous situation, and about institutionalization without a court decision, but by the police for strange behaviour on the street. Costa Rica has ratified OPCAT, so she asked whether there is an NPM and what is it doing; does it also monitor clinics where people are held by force?
We were so proud of these questions: so proud of the recognition of the horror of forced psychiatry which we achieved here, and so proud of the CRPD Committee for acknowledging the suffering and taking a stand. It was a wonderful moment for us, and it really made our day. We know that the jurisprudence by the CRPD Committee’s Concluding Observations is firmly against forced psychiatric treatment, and we are looking forward to the Concluding Observations of Costa Rica. I also really hope that the government of Costa Rica then will implement these recommendations and stop the suffering in psychiatric institutions in Costa Rica. That would really mean a lot in the lives of persons with psychosocial disabilities in Costa Rica. We really hope that the people will be freed. The attention for the topic of forced psychiatric interventions/ forced treatment/ forced institutionalization really made us, the WNUSP-delegation, very happy.

After the questions there was a 15 minute break, to enable the delegation of Costa Rica to prepare for answering. There was limited time, so there came only a short answer on the theme of forced psychiatry. Regarding NPMs under OPCAT, there is an Ombudsman which can perform visits, and they have a unit that deals with the rights of persons with psychosocial disabilities. It sounded again like: “we are working on it, but it’s not yet effective”. Unfortunately they answered on involuntary commitment that they were building a new “correctional facility” (forensic psychiatry).

It has been a good session. We are happy and proud that the rights of persons with psychosocial problems are included. And personally I am proud that I can be an advocate to stop these horrible practices, and I feel so empowered by this successful morning with the CRPD Committee. Really good.

Then after the lunch, we all went to a side-event of Autism Minority International. It was a very interesting event. They presented autism as a minority, as natural diversity of mankind, entitled to all rights. That was a very clear message. They were also against medicalization and forced treatments. One of the speakers preferred to be not-present, because he knew he couldn’t handle big conference rooms, so he made a statement via text-to-voice and he was available on Skype for questions. He basically said that it shouldn’t matter which means of communication one chooses. The third speaker was an architect and spoke about a study on architectural aspects to accommodate persons with autism, such as reduced acoustics. This could be useful to enable further inclusion of persons with autism in the community. It was really interesting, although I found the computer-voice a bit hard to follow. But the message was clear, and that was exactly the point he made.

After the side event, Tina, Hege and I talked with Erich Kofmel, president of Autism Minority International. I left early from the informal meeting, because I had an appointment to interview the 2 CRPD Committee Vice-Chairs: Theresia Degener and Carlos Rios. This was the second great thing that happened today. Theresia Degener and Carlos Rios explained the CRPD standards in a video message for the upcoming Dutch annual Spring Congress of the Dutch Association of Psychiatrists (NVVP), where I am organizing a discussion session called: “social motivation in the 21st century: the UN CRPD”. I like the video message, and I surely think it will have impact among Dutch psychiatrists who join our session in the Netherlands next week at 9 April 2014. I am so proud that I have this message, to be able to counter the argument “you only see what you want to see”. I can now prove it is REAL! Forced psychiatric interventions are in violation of human rights.

With my photo-camera in my backpack (like a stash of gold) and my head up high I left Palais Wilson, and found the others at The Clubhouse. We decided to have a Chinese/Indonesian dinner again, which was delicious. After that we went home to the apartment and we drank some tea and then started to chat again. Liv and I sat on the balcony again, talking on and on till about 1.00 midnight, and then I still had to finish my blog. However, tomorrow we will have a meeting not earlier than 11.00, so we can sleep a bit longer than the other days. That is really welcome. So that is what I will do now. It was a really great day. I am happy :)