JEAN-JACQUES GAUTIER NPM SYMPOSIUM 2016
amount to ill-treatment or torture, with the aim of better protecting
the rights of persons with disabilities.
Monitoring bodies, and NPMs in particular, have a central role to
play in protecting the rights of individuals deprived of liberty in
psychiatric institutions – a monitoring role increasingly exercised
in several regions around the world. Their preventive mandate
under the OPCAT, which ensures privileged access to all places of
deprivation of liberty - both public and private - (in the broad sense
of the definition contained in article 4 of the OPCAT), places them
in a unique position to report on the reality of deprivation of liberty
and to question it with a view to improving practices.
Despite the diversity of the social, political and cultural contexts
in which NPMs operate, and the diverging practices pertaining
to the treatment of persons with mental disabilities, these bodies
face similar challenges in the monitoring of psychiatric institutions,
both on fundamental substantive issues and on the methodological
approach to be adopted before, during and after the visits.
In light of the diverging international standards governing involuntary
placement and treatment of persons with mental disabilities, which
renders their implementation all the more difficult, NPMs’ main
governing principle should be non-discrimination. This principle
includes an acknowledgement of the paradigm shift, which assumes
that the individual has the capacity for independent decisionmaking. In other words, the move from a system of “substitute”
decision-making to a system of “supported” decision-making.
At the end of the Symposium, it was concluded that NPMs (and other
monitoring bodies) should be encouraged to consider the following
issues to better protect persons with mental disabilities and promote
alternatives to institutionalisation in favour of life in the community:
• check that the treatment is always individualised and question
practices (such as the use of seclusion and physical or chemical
restraint) that may amount to torture or other forms of illtreatment;
• ensure visiting teams are multidisciplinary and made up of
healthcare specialists but also non-specialists, in order to benefit
both from medical expertise but also from a range of points of
view on the methods of treatment observed;
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