Tortured minds: psychiatry and human rights

ABC Radio National’s All the the Mind has just concluded a two part series on human rights and psychiatry that looks at the role of mental health professionals in military interrogations, and the rights of psychiatric detainees.

The first part is based at the World Psychiatric Association conference in Australia and interviews several psychiatrists about their views on whether mental health professionals should be involved in, most relevantly, ‘war on terror’ interrogations that some argue are tantamount to torture.

The response is a bit predictable as psychiatrists have already firmly decided to have no part in these interrogations which they see as incompatible with their oath to ‘do no harm’, unlike the American Psychological Association which has decided to endorse participation within some rather vague limits.

There’s a particularly interesting contribution from psychiatrist Prof Steven Sharfstein, who as president of the American Psychiatric Association was taken to Guantanamo Bay by the US Government, presumably to reassure him and other clinical leaders that the horror stories about the place were unjustified.

Instead, he came away convinced that Guantanamo should be closed for good.

In contrast, the American Psychological Association president, Prof Ronald Levant, who attended the same visit, came away with no strong convictions that any unethical practices were taking place.

The second part of the All in the Mind special investigation looks at the treatment of psychiatric patients across the world, particularly focusing on parts of the developing world where asylums can sometimes be little more than prisons.

The programme mentions a 2003 edition of Time Asia which had a photo essay on some of the shocking conditions in some Asian institutions.

It also discuss the newly agreed UN Convention for the Rights of Persons with Disabilities which is likely to have a significant impact on the rights of people with mental difficulties.

One of the most interesting contributions is from psychiatrist Prof Vikram Patel who headed up the excellent Lancet series on Global Mental Health.

It was a fantastic series of articles, including a paper entitled ‘Barriers to improvement of mental health services in low income and middle income countries’ which identifies education and funding as two key factors, and another called ‘Resources for mental health: scarcity, inequity, and inefficiency’.

Without a hint of irony, the series is closed-access and individual articles are charged at $30 each.

The last in the series of article urges the global mental health community to “scale up the coverage of services for mental disorders in all countries, but especially in low-income and middle-income countries”.

So I’ve uploaded all the articles to the web. Enjoy.

No health without mental health [pdf]

Resources for mental health: scarcity, inequity and inefficiency [pdf]

Treatment and prevention of mental disorders in low-income and middle-income countries [pdf]

Mental health systems in countries: where are we now? [pdf]

Barriers to improvement of mental health services in low income and middle income countries [pdf]

Scale up services for mental disorders: a call for action [pdf]

Link to AITM on participation in interrogation or torture.
Link to AITM on ‘Who speaks for the chained and incarcerated?’.
Link to 2003 Time Asia article and photo essay on Asia’s mental health centres.

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