We heard widespread criticism of laws that allow people to be denied their human rights after being diagnosed with a psychiatric condition. Compulsory treatment, seclusion and restraint under the Mental Health (Compulsory Assessment and Treatment) Act 1992 (Mental Health Act) was described as a breach of fundamental human rights, in contravention of New Zealand’s obligations as a signatory to the United Nations Convention on the Rights of Persons with Disabilities and the Declaration on the Rights of Indigenous Peoples. People argued that the Mental Health Act embeds archaic and risk-averse attitudes that cause clinicians to opt too readily for coercion and control when other options are available. Many people saw forced treatment as inhumane, undermining self-determination and causing significant trauma.
People welcomed the Health Quality and Safety Commission’s initiative to end seclusion by 2020 and expressed frustration that it is taking so long for all DHBs to implement practices that make seclusion unnecessary. Many submitters pointed to the persistently higher rates of compulsion and seclusion for Māori and Pacific peoples, saying that the legislation legitimises unconscious bias and institutional racism.
People asked for legislative reform that would guarantee human rights, minimise the use of compulsion and seclusion in inpatient units, and require an approach to mental health and addiction that lifts the spirit and restores dignity.
We heard that people facing mental health or addiction challenges are often reluctant to seek help for fear of encountering negative attitudes from health practitioners and being subject to restraint, seclusion, the removal of their children, separation from family, loss of employment and suspension of their human rights. We were told that often the result is a worsening of their condition until they eventually enter the system under a compulsory treatment order or enter the criminal justice system.
We also heard that the legacy of shame and stigma that has surrounded mental health remains a barrier to seeking help. People agreed that awareness and understanding of mental health challenges has improved in recent years, thanks to promotional campaigns and the actions of thought leaders in many sectors, including sport, business and the arts. But they said shame and stigma continue to shape attitudes and are embedded in our laws and the way services are structured and delivered.