The Detention of Persons with Psychosocial and Intellectual Disabilities: The Belgian System and Its Compliance with the UN Convention on the Rights of Persons with Disabilities

De Beatriz Scotton

This book analyses States Parties? obligations under the UN Convention on the Rights of Persons with Disabilities with regard to the detention of persons with psychosocial and intellectual disabilities with the purpose of psychiatric treatment. The main provisions of the CRPD discussed in this book are Articles 12 and 14, on the right to equal recognition before the law and the right to liberty and security, respectively. Furthermore, the book provides an overview of the Belgian system of detention of persons with psychosocial and intellectual disabilities for psychiatric treatment, which includes the analysis of key provisions of Belgian national legislation such as the Act on Confinement of 2014, the Act on Mental Health of 1990 and the national directive on the mental health care delivery sector, the 107 Reform, in progress since 2011. Both national legislation and mental health policy are considered in relation to its compliance with the obligations and standards established in the CRPD. Besides, this book contains recommendations to Belgium in relation to its system of internment, which take into consideration the CRPD Committee Concluding Observations on Belgium, various reports and relevant academic discussions on the topic.
Este livro, cujo conteúdo está em língua inglesa, examina as obrigações dos Estados parte da Convenção Internacional sobre os Direitos da Pessoa com Deficiência, com foco na detenção de pessoas com deficiência psicossocial e intelectual para tratamento psiquiátrico. Os principais artigos da Convenção examinados neste livro são os artigos 12 e 14, sobre o direito ao igual reconhecimento perante a lei e o direito à liberdade e segurança da pessoa, respectivamente. O livro constrói um panorama do sistema belga de detenção de pessoas com deficiência psicossocial ou intelectual para tratamento psiquiátrico, o que inclui a análise dos principais dispositivos de leis nacionais belgas, como a Lei de Internação de Pessoas de 2014, a Lei de Proteção às Pessoas com Doença Mental de 1990 e a diretriz nacional em cuidado e saúde mental, a Reforma 107, em curso desde 2011. Tanto a legislação quanto a política de saúde mental são desenvolvidas a partir do cumprimento das obrigações e das normas estabelecidas na Convenção. Além de tudo isso, o livro contém recomendações ao Estado belga em relação ao sistema de internação, com a consideração das Observações Conclusivas do Comitê sobre a Bélgica, relatórios diversos e discussões acadêmicas pertinentes.

• Idioma: Português
• Editora: Editora Dialética
• Data de lançamento: 26 de jul. de 2021
• ISBN: 9786525204406

Pré-visualização do livro

capaExpedienteRostoCréditosUma imagem contendo colorido, trem, homem, mesa Descrição gerada automaticamente

NO TITLE, 1948

Painting of Carlos Pertuis,

interned in the Psychiatric Hospital of Praia Vermelha, Rio de Janeiro,

between 1939-77

Images of the Unconscious Museum, RJ

Photographic Reproduction of Humberto Moraes Franceschini

SEM TÍTULO, 1948

Pintura de Carlos Pertuis,

internado no Hospital Psiquiátrico da Praia Vermelha entre 1939-77,

no Rio de Janeiro

Museu de Imagens do Inconsciente, RJ

Reprodução fotográfica Humberto Moraes Franceschini

On est des humains quand même! On est des humains...¹

Sou como a sombra da caverna de Platão, não sou um monstro.²

---

1 Words of Jacques, interned in a Social Defence Facility , Belgium, 2015. (Palavras de Jacques, internado em Estabelecimento de Defesa Social, Bélgica, 2015). In ‘Paroles en défense sociale Paroles de défense social – Ce qui fait soin dans um parcours en défense sociale? Le point de vue des personnes sous statut interné’, Yolande Verbist , ASBL Psytoyens, 2015.

2 Notes of Mussalém, interned in Franco da Rocha Forensic Hospital, São Paulo, 1999 (Anotação de Mussalém, internado no Hospital de Custódia de Franco da Rocha, São Paulo, 1999). In ‘A Casa do Delírio: Reportagem no Manicômio Judiciário de Franco da Rocha’, Douglas Tavolaro. 2004, Publisher Editora Senac.

ACKNOWLEDGEMENTS

First of all, I would like to thank Andrea Broderick, my academic supervisor, not only for carefully reading these pages, refined commentaries, and teachings but also for the complete support and encouraging words and for the kind and inspiring person she is. A special thanks to Isabela Viriato, Viviane Balbuglio, Cristina Patriarca and Felipe Roessler, who patiently listened to my endless considerations about the same subject for several months, for reflecting with me on the main issues raised in this thesis, and for being informal reviewers of these writings. It would be impossible to complete this work without them by my side. To my family and friends, thanks for staying beside me, even with an ocean in between us. Finally, I would like to thank the Dialética Publisher for the invitation to publish this master’s thesis and for the fantastic assistance during the publication process.

NOTA DE AGRADECIMENTOS

Primeiramente, gostaria de agradecer à minha orientadora, Andrea Broderick, não só pela atenta leitura, pelos acertados comentários e pelos ensinamentos, mas também pelo acolhimento, pelas palavras encorajadoras e pela pessoa generosa e inspiradora que é. Um agradecimento especial à Isabela Viriato, Viviane Balbuglio, Cristina Patriarca e Felipe Roessler, que pacientemente me escutaram falar sobre o mesmo assunto por meses a fio, refletiram comigo sobre as principais questões desta tese e também foram revisores informais destes escritos. Seria impossível completar esse trabalho sem vocês. À minha família, obrigada por se manterem próximos enquanto eu escrevia este trabalho em Maastricht, mesmo com um oceano de distância entre nós. Finalmente, gostaria de agradecer imensamente a Editora Dialética pelo convite, pelo fantástico trabalho e por todo o suporte que me deram durante o processo de publicação deste livro.

CONTENTS

Capa

Folha de Rosto

Créditos

LIST OF ABREVIATIONS

1. INTRODUCTORY CHAPTER

1.1 INTRODUCTION

1.2 RESEARCH QUESTIONS

1.3 METHODOLOGY

1.4 STRUCTURE

2. A BRIEF SOCIO HISTORICAL CONTEXTUALISATION

2.1 INTRODUCTION

2.2 AN OVERVIEW OF THE INSTITUTIONALISATION OF PERSONS WITH DISABILITIES

2.3 THE THEORETICAL MODELS OF DISABILITY AND MODELS OF EQUALITY

2.3.1 THE MEDICAL MODEL OF DISABILITY AND THE FORMAL EQUALITY APPROACH

2.3.2 THE SOCIAL MODEL OF DISABILITY AND THE SUBSTANTIVE EQUALITY APPROACH

2.3.3 THE HUMAN RIGHTS MODEL OF DISABILITY AND THE INCLUSIVE EQUALITY APPROACH

2.4 THE CRPD AS ANACHIEVEMENT OF THE DISABILITY RIGHTS MOVEMENT

3. INTERPRETATION OF STATES PARTIES’ OBLIGATIONS UNDER THE CRPD

3.1 INTRODUCTION

3.2 LEGAL INTERPRETATION OF ARTICLE 12

3.2.1 ARTICLE 12, PARAGRAPHS 1 AND 2

3.2.2 ARTICLE 12, PARAGRAPH 3

3.2.3 ARTICLE 12, PARAGRAPHS 4 AND 5

3.3 LEGAL INTERPRETATION OF ARTICLE 14 OF THE CRPD

3.3.1 ARTICLE 14, PARAGRAPH 1

3.3.2 ARTICLE 14, PARAGRAPH 2

3.4 THE CRPD COMMITTEE’S CONSIDERATIONS CONCERNING INDIVIDUAL COMMUNICATIONS

4. BELGIAN LEGISLATION ON THE DETENTION OF PERSONS WITH PSYCHOSOCIAL AND INTELLECTUAL DISABILITIES

4.1 INTRODUCTION

4.2 THE ACT ON CONFINEMENT (LOI RELATIVE À L’INTERNEMENT DES PERSONNES)

4.3 THE MENTAL HEALTH ACT (LOI RELATIVE À LA PROTECTION DE LA PERSONNE DES MALADES MENTAUX)

4.4 REFORM 107 (RÉFORME 107)

5. COMPARISON AND RECOMMENDATIONS

5.1 CHAPTER’S SUMMARY

5.2 STATES PARTIES’ OBLIGATIONS UNDER THE CRPD AND THE ACT ON CONFINEMENT

5.2.1. ARTICLE 12 AND RELATED PROVISIONS

5.2.2 ARTICLES 14 AND 25

5.2.3 PRACTICES AND BREACHES OF THE CRPD

5.3 STATES PARTIES’ OBLIGATIONS UNDER THE CRPD AND THE ACT ON MENTAL HEALTH

5.3.1. ARTICLE 12 AND RELATED PROVISIONS

5.3.2 ARTICLE 14

5.3.3 PRACTICES AND BREACHES OF THE CRPD

5.4 RECOMMENDATIONS ON THE BELGIAN SYSTEM

5.4.1 RECOMMENDATIONS ON THE BELGIAN SECURITY MEASURES SYSTEM

5.4.2 RECOMMENDATIONS ON THE BELGIAN PROTECTION MEASURES SYSTEM

5.5 FINAL CONSIDERATIONS

6. CONCLUDING REMARKS

6.1 SUMMARY OF THE MAIN CONCLUSIONS

6.1.1 STATES PARTIES’ OBLIGATIONS UNDER ARTICLES 12 AND 14

6.1.2 THE RELATION OF ARTICLES 12 AND 14 WITH OTHER PROVISIONS OF THE CRPD

6.1.3 THE BELGIAN SYSTEM AND ITS COMPLIANCE WITH THE CRPD’S STANDARDS

6.2 A CONSIDERATION OF CURRENT CHALLENGES

6.3 CONCLUSION

AFTERWORD

POSFÁCIO

BIBLIOGRAPHY

Landmarks

Cover

Titlepage

Copyright-page

Table of Contents

Bibliography

LIST OF ABREVIATIONS

Disabled Persons Organisations (DPOs)

European Committee for the Prevention of Torture (CPT)

European Convention on Human Rights (ECHR)

European Court of Human Rights (ECtHR)

International Covenant on Civil and Political Rights (ICCPR)

International Covenant on Economic,

Social and Cultural Rights (ICESCR)

Non-Governmental Organisations (NGOs)

Persons with Disabilities (PWD)

United Nations (UN)

World Health Organisation (WHO)

International Committee of the Red Cross (ICRC)

United Nations Children’s Fund (UNICEF)

United Nations Committee against Torture (UN CAT)

United Nations Committee on the Rights of Persons

with Disabilities (CRPD Committee)

United Nations Convention on the Rights of Persons

with Disabilities (CRPD)

Vienna Convention on the Law of Treaties (VCLT)

1. INTRODUCTORY CHAPTER

1.1 INTRODUCTION

The United Nations Convention on the Rights of Persons with Disabilities (the ‘CRPD’ or the ‘Convention’), adopted in 2006 and with entry into force in May 2008, ³ with its Optional Protocol, ⁴ is essentially a ‘non-discrimination instrument’ ⁵ with the purpose and objective to ‘promote, protect and ensure the full and equal enjoyment of all human rights and fundamental freedoms by all persons with disabilities, and to promote respect for their inherent dignity’, as stated in Article 1 of the CRPD. As pointed out by Gerard Quinn, the majority of rights recognised by the Convention are those that were already enshrined in United Nations (‘UN’) human rights treaties, such as the International Covenant on Civil and Political Rights (‘ICCPR’) and the International Covenant on Economic, Social and Cultural Rights (‘ICESCR’). However, these treaties did not in fact benefit persons with disabilities, due to their invisibility both in society and in the treaties monitoring bodies. ⁶

One of the ‘classical’ human rights recognised by the international community is the right to liberty and security.⁷ Nonetheless, in several countries worldwide, persons with mental impairments or illnesses (hereafter ‘psychosocial disabilities’) and those with intellectual disabilities are treated in a discriminatory manner and are detained against their will in institutions, in the name of treatment. Article 14 (1) (b) of the CRPD provides that ‘the existence of a disability shall in no case justify a deprivation of liberty,’ which must be considered an unlawful or arbitrary detention.

The cases of involuntary detention of persons with psychosocial and intellectual disabilities for their treatment is directly linked to the denial of legal capacity, another inherent right traditionally denied to persons with psychosocial and intellectual disabilities in legal systems worldwide. As stated by the Committee on the Rights of Persons with Disabilities (CRPD Committee)⁸ in its General Comment no. 1,⁹ involuntary treatment and the denial of legal capacity are strictly related, due to the fact that many persons are institutionalised without their consent or with the consent of a substitute decision-maker. Globally, persons with psychosocial and intellectual disabilities are still not recognised as holders of rights and duties.

Following the paternalistic tradition of treating people with disabilities as ‘incapable,’ many criminal laws do not recognise the responsibility of offenders with a psychosocial or intellectual disability when the impairment is deemed to affect their capacity of discernment or control over their acts. The negation of criminal responsibility is used to justify forced institutionalisation of psychosocial or intellectual disabled offenders in a secured mental health hospital or in the psychiatric annex of a prison, sometimes with no limit of time. A similar approach is taken to people with psychosocial or intellectual disability who are considered to be a threat to themselves or to others, even though no crime was committed.

On the surface, the Belgian legal system is committed to the obligations and values enshrined in the CRPD¹⁰ regarding the treatment of psychosocially and intellectually disabled persons, since the country has even established reforms in the health system to better treat this specific group. Despite the commitment of sectors of mental health professionals to changing practices, the European Court of Human Rights (‘ECtHR’) has ruled, twenty-three times,¹¹ that Belgium has breached provisions of the European Convention on Human Rights (‘ECHR’), as a result of its internment policy. This demonstrates that institutionalisation policies and practices related are sensitive issues in Belgium, which has measures of control, such as security and protection measures, provided by its national law.

This thesis will deal with compulsory measures of institutionalisation in the Belgian system, in the light of the provisions of the CRPD, a treaty which ‘forces an acknowledgement of the contradiction between our universal values and our practice on disability throughout the world.’¹² This contradiction is entrenched in our society, resulting in a deep marginalisation and exclusion of persons with disabilities. The fact that the CRPD is a very recent human rights treaty, the first of the twentieth-first century, indicates that we have only begun to recognise and to face disability issues, which means that there is still a long way to go to effectively transpose the CRPD provisions into practice.

The objective of this thesis is to analyse whether measures of involuntary institutionalisation, in the Belgian context, are in line with the provisions of the CRPD and contribute to the current discussion about the rights of persons with disabilities.

1.2 RESEARCH QUESTIONS

The main research question addressed by this thesis is as follows: are Belgium law, policy and practices with regard to the