Mental Illness, Discrimination and the Law: Fighting for Social Justice

Citation

Stevens, A. (2013), "Mental Illness, Discrimination and the Law: Fighting for Social Justice", Journal of Public Mental Health, Vol. 12 No. 2, pp. 114-115. https://doi.org/10.1108/JPMH-10-2012-0019

The focus of the book is on how legislation, within realistic limits, can advance rights and entitlements of mental disordered citizens of countries signed up to the 2006 UN Convention on the Rights of Persons with Disabilities (CRPD). It is derived from an international review of legal changes that have reduced disability discrimination and improve the lot of people with mental health problems. The review was initially commissioned by the Association for the Improvement of Mental Health Programmes prior to the CRPD being enacted, but the world‐wide information was reviewed by expert authors (from England, Canada, Germany and Brazil) in its wake. This is a review of best practice, rather than being a comprehensive overview of the effectiveness of legal protection and acknowledged preponderance of case studies from English‐speaking, high‐income countries – in part because of these being the more progressive – but it is not exclusive to these areas.

The bulk of the book considers the improved access and protection powers offered by progressive legal cover in areas such as capacity, political participation, work, education, housing, social welfare and health services. It also cover legal protection from research exploitation, consent to treatment. There are some interesting issues addressed, such as the blanket ineligibility in England of anyone one who has or has had a mental disorder from jury service (which could exclude about half of its citizens!). The authors describe the forms of discrimination and barriers to access within each of these areas and the influence of legislation to ameliorate these issues. Their account of employment and workplace appears to be fair, but there is no discussion of the relative success of racial and sexual discrimination in comparison to that related to disability. Research into local government employment, for example, indicates improvements over a decade in employment of women and black people in managerial grades, but not disabled people. Consolidation of discriminatory legislation into “Equalities” acts may in practice be helpful to employers, but not particularly for disabled people. These issues are not identified. Employment targets and affirmative action (such as in Japan and Brazil) are mentioned, but no particular case is made for particular approaches. Similarly, in relation to housing, there is a case study of the Italian law regarding deinstitutionalisation (Mental Health Law 180) with only references for the reader to discover its effects, except to say that such approaches do not necessarily promote “independent living”.

The chapter on legal implementation and enforcement provide much clearer direction regarding leadership, mainstreaming, auditing, profession, service user and carer participation, inspection, hearings and the role of ombudsmen, which is a little lacking in earlier chapters. One chapter provides the CRPD full text and summaries of international and regional legislation and another gives national examples of disability legislation which could be useful reference material.

Despite a great deal of information and measured consideration of the issues, two important criticisms can be levelled at this book. First, it is a report by a committee with no dissenting members. These eight eminent authors clearly will have different, possibly polemic viewpoints, which are absent from the completed work. This could be a reason for its overall conservative approach. Second, the mode of publication, as a hardback book, rather than on internet will restrict its access to people in low‐income countries who could most use it.