MONITORING PSYCHIATRIC INSTITUTIONS is therefore essential for visiting teams to take the time, at the start of each visit, to explain why they are there, what they will be doing and to break down this initial resistance. Towards a paradigm shift: the Convention on the Rights of Persons with Disabilities For a long time, an exclusively medical approach to mental disability has prevailed and psychiatrists’ opinions have never or rarely been questioned. This situation has led to the wishes of persons with mental disabilities being ignored as they were, and in practice still are, considered “incapable” of making independent decisions. The participants mentioned that there is a power game behind the medical community’s reticence to be supervised by independent bodies protecting human rights, such as the NPMs, as the psychiatric body has a “monopoly” on care and, in some cases, has also been entrusted by the government authorities with the mission of “social control”. In many countries, this power is compounded by stigmatisation and discrimination towards persons with mental disabilities in a society that tends to accept the incarceration of persons who are assumed to be dangerous. The place and role of families in institutionalisation is an issue that was raised several times during the Symposium. Social stigma, as well as the absence of support and suitable structures in the community, contribute to families “abandoning” a relative with a disability in closed institutions. This situation is particularly serious in societies with strong superstitions, and in which families use traditional healers who offer treatments that can present serious risks to a person’s physical and mental integrity and are not subject to any outside inspection. Nevertheless, it was pointed out that, in certain countries, such as Senegal, the family plays an integral role in the care, ensuring more compassionate treatment and a more humane environment, as well as an easier return to society following hospitalisation and thus avoiding a long-term separation from life in the community. Based on these findings and traditional discrimination towards persons with mental disabilities, the Symposium’s participants acknowledged the need for a change in their approach to accepting these individuals as subjects of rights and not as ”objects” of medical 11