JEAN-JACQUES GAUTIER NPM SYMPOSIUM 2016
and the SPT discussed the role of psychiatrists within the team and
the advantages and disadvantages of their presence within visiting
teams.
Psychiatrists have the benefit of specialised medical knowledge
and are able to assess the relevance of the care, the quality of the
proposed treatment and can therefore add more legitimacy to the
NPM. However, their presence can also be perceived with suspicion
by the users as it has strong associations with their experience in the
institution. Moreover, it is not necessarily apparent to psychiatrists
that their role as members of a human rights monitoring body should
prevail over their role as a doctor in the interests of the persons
who are deprived of liberty. The psychiatrist’s point of view should
therefore be contrasted with that of their non-specialist peers to
allow for a discussion within the team before, during and after the
visits, and establish a common approach to the monitoring between
specialists and non-specialists.
“Non-psychiatrists play an essential role to counteract the
professional biases of psychiatrists. Non-psychiatrists are more
sensitive to the dehumanising effects of some psychiatric
institutions and ask sensible questions about patients’ everyday
living conditions. They also understand how important private
interviews with patients are conducted to probe for possible
abuses, even with acutely disturbed, psychotic patients and
patients in seclusion and/or physically restrained.”
Timothy Harding, Expert-psychiatrist, CPT
In practice, several NPMs lack medical expertise in their team. To
make up for this, psychiatrists are often included as external experts
and only join the NPM team for visits. This offers the aforementioned
benefits but also provides an additional challenge: a shared common
vision/understanding of the preventive mandate of monitoring that
transcends the professional background of each of the members of
the visiting team. The discussions led to the conclusion that, while a
psychiatrist’s presence in the NPM brings added value, one does not
need to be a specialist to evaluate the merit of certain practices and
their potential negative impact on human rights.
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