Human Rights Committee session on Japan

Today I went to Palais des Nations (the big UN building), and the main subject today was Japan, and the rights of persons with psychosocial disabilities.
I got up a little late, and arrived at Palais des Nations around 11 AM, where I met the Japanese delegation (Yoshi, Mari, Yoshiko and Reiko) at a quiet cafeteria-room called Salle des Assemblees. Vicky from IDA (International Disability Alliance) also joined us.

We were very shocked to find out that the security of Palais des Nations had forbidden to bring the picture boards with images of a 33 year old Japanese male who was beaten to death in seclusion. The pictures showed surveillance camera screen shots of psychiatric nurses stamping on the head of the guy, while he was laying on the ground. He died of a broken neck. The images speak for themselves, and are really a reality in a lot of places in the world. But the security called the pictures “too grotesk” (!!), and searched the bags of the Japanese delegation (!!) and then also confiscated the Japanese parallel reports that were supposed to be handed out to the Human Rights Committee members (!!!!!!). This censorship is outrageous!! Why does the security take away these materials that were brought to the UN all the way from Japan to raise awareness on human rights violation?? This is repression at the cost of the many people in Japanese psychiatric institutions (the highest number of forced institutionalization on Earth). The security should have applauded for the Japanese delegation for bringing these issues to the UN, but instead they forbid spreading the copies of the NGO-reports (!!). How dare they!!! It should be the Human Rights Committee who should decide whether something is acceptable/appropriate or not. The substance of reports is not a matter for the security personnel. We were all shocked and we didn’t understand why the security did this.

The parallel report on Japan of the Japan National Group of Mentally Disabled People and WNUSP and IDA, including the pictures, can be found here: http://www.ccprcentre.org/doc/2014/06/INT_CCPR_CSS_JPN_17418_E.pdf

We all agreed that we should send a written complaint to the UN, about this blunt error of the security at Palais des Nations. This isn’t over yet!

We talked a bit more, and then we prepared ourselves for the second NGO meeting on Japan. Once more Reiko practiced the pronunciation of some hard English words for her presentation on forced sterilization on disabled women. Yoshi was the one who was going to speak about the human rights in mental health care in Japan (forced institutionalization, violence, abuse, deficiency of community support, failing mental health review boards and so on). He was also well prepared.

Then around 13.00 we went to meeting room XII for the second NGO meeting on Japan, that would start at 13.30. A big delegation of Japanese NGOs had gathered in the room, but unfortunately the Human Rights Committee members were half an hour late, so the session started around 14.00. Again many issues were raised. Every speaker had 1 or 2 minutes to make a presentation. Themes were: death penalty (about 10x a year) and treatment of persons in deathrow (solitary confined for “peace of mind”) and a case of a person who spent 40 years in deathrow whose case is now re-opened. Prisoners rights, sex slavery during WW2, discrimination in housing, discrimination of migrants and refugees, discrimination of Korean residents (especially the governmental exclusion and public violence towards Korean schools), the forced dismissal of an airline staff, freedom of education (without mandatory greeting of the Japanese flag and the anthem - teachers who criticize this practice are at risk of punishment), the rights of children with disabilities to safety and support (including sexual education in special needs schools), the registration of “not-legitimate children” in case of unmarried parents and recognition of the father, decriminalization of abortion, lack of policy and support around domestic violence (high numbers: every 3 days a woman dies of domestic violence in Japan), sexual rights (including women, minors and recognition of LGBT, and non-discrimination in re-marriage (the woman has to wait at least 6 months before re-marrying).
Yoshi gave a very good and structured presentation of the main themes on the rights of persons with psychosocial disabilities:
1. vague criteria for institutionalization resulting in arbitrary detention (number of institutionalized persons is 4x as high as general OECD countries).
2. High dependency on mental health institutions due to a lack of community support (97% of state mental health budget goes to institutions, and only 3% for community support)
3. the dysfunction of the mental health review board and procedures (50% of persons in institutions are there only because they have no other place to go).
4. the abuses in psychiatric hospitals, including deaths (hospitals without monitoring).
Also Reiko’s presentation on forced sterilization of women with disabilities went very well.

There was only 10 minutes of time for the Human Rights Commmittee members to ask some clarifying questions, and nothing was asked about mental health related issues. That means the information was probably clear.

After the NGO briefing we went straight to the main meeting room (room XX, where I had received the annual report of the Special Rapporteur in March 2014, it still is a special room for me). There, the official session of the Human Rights Committee with the Japanese government took place. Tina Minkowitz and Hege Orefellen had also arrived. We all observed the process of questions and answers.

First the government of Japan presented their periodic report based on the List of Issues as defined by the Human Rights Committee. The Japanese government presented a nice story and made it seem like there was no problem. On mental health issues they said that the mental health laws are being revised, to shift from medicalization and hospital-based care to community living (but we know they are renaming hospital units as “residential group homes” with very little change in practice). The government also said they were reviewing the procedures for involuntary hospitalization, and aiming to facilitate discharge (but we know only 3% of budget goes to community support, and many persons simply have no place at all to go to, the families don’t want the burden). Also it was claimed that NGOs monitor the quality of psychiatric hospitals (but we know that closed institutions are not open for NGOs, lawyers and even family members have to push hard to be allowed to visit, because the hospital claims that patients need rest and peace and no outside interference). It was rather interesting to compare the government’s story with what we already heard from the NGOs.

The presentation of the Japanese government delegation was rather long, and was followed by the first round of questions by the Human Rights Committee members. Mr. Neuman raised questions on involuntary detention of persons with “mental illness” (his language wasn’t really CRPD-compliant, but he made an effort to raise the issues). The many private psychiatric hospitals seem to have a conflict of interest and continue to institutionalize persons involuntary (gaining corporate power). He asked whether damage to others also includes “damage to reputation” for example of family members, since he heard that people are institutionalized not because they need institutionalization, but because the family doesn’t want to take care of them. And now Japan is starting to increase community support, but there is a long way to go since there are 300.000 people in institutions, and 50.000 people are only there because they have no other place to go. He also questioned the plan for group homes and care homes: if these are in the same hospital it is not so very different. Mr. Neuman also mentioned the allegations of abuse in closed environments, and he added that closed environments with vulnerable patients and no outside witnesses are always a suspicious place where abuse can happen easily. Japan has ratified the CRPD, which implies a change (paradigm shift). Community support for persons with psychosocial disabilities is needed, and “involuntary hospitalization should be used as a last resort and reduced to a minimum” (that last remark was pretty bad, since the last-resort-approach was replaced by the CRPD-principle of equal right to live in the community, but still, it was positive that he raised the theme).
A little bit later also mr. Zlatescu raised questions on the theme of mental health. (his language was a lot better, he really is aware of the CRPD!). He asked about the abuse and injury in psychiatry, and mentioned the recent case of the 33-year old male that was beaten to death in seclusion. He added that this is not an isolated case, and he started reading out several examples from the parallel report of the Japan National Group of Mentally Disabled People: 1980: a nurse injured a patient resulting to death. 1985: a nurse hit an inpatient an fractured his skull. 1997 two nurses hit an inpatients head against the wall. She died. And so on, and so on… This is not a new theme. What measures are taken to prevent abuse, to investigate and to repair the damages? The plan to revise mental health laws to make the shift as enshrined in the CRPD is very welcome, but what is done to ensue free and informed consent? He added: “this is also referring to the question of my colleague” (he somehow rephrased the question of Neuman in a more CRPD-compliant way). Also training and education on consent would be welcome. Is there a strategy for de-institutionalization and the establishment of community based services and budget for development, and does this all include meaningful consultation of persons with mental disabilities?
Mr. Zlatescu’s questions were very good, and we were all very happy with his move.

After the Human Rights Committee members had asked their first round of questions, the government was asked to provide their answers to these questions. The Japanese government didn’t yet reply on the mental health theme (maybe tomorrow), but on other issues they did reply, such as on death penalty. It was said that the Japanese public opinion is in favour of death penalty, and it is seen as “unavoidable for atrocious crimes”. In Japan, they are discussing the issue of death penalty, but it is not realistic to prohibit it, because of the public opinion. This argument was terrible: like the government has no steering role, no responsibility, and only depends on the public opinion. This sounded like the Japanese government has no power and isn’t in control, which is of course untrue. These type of arguments were repeated at various points. And exactly at 18.00 the government stopped talking. The session had ended.

Afterwards the Japanese NGO network gathered to discuss and identify priority issues for follow up consideration, which took about half an hour, and then the day was done. At around 19.00 we left Palais des Nations (and on the way out, Yoshi went to the security to pick up the materials that were taken away from them this morning).

It had been an interesting session. And although the Japanese government delegation was sometimes making a bit of a fool of themselves, Japan can be proud of their active NGOs that defend human rights. They did a great job today!

At 19.30 we were supposed to meet each other at a Vietnamese restaurant in the centre of Geneva for dinner. We were with about 11 people: Mari, Yoshi, Reiko, Yoshiko, Tina, Hege and her collegue, and also Vicky (IDA) and Facundo Chavez (OHCHR Disability Focal Point) and Alma (with her cute baby-daughter) and me. It was really nice, I enjoyed both the company and the food. And then the day was done, and we walked back to the station and all went to our hotels or home. And now it suddenly is very late at night again, so I will go to sleep now. Tomorrow is another important day :)