January 22, 2010

From Privileges to Rights:

From Privileges to Rights: People Labeled with
Psychiatric Disabilities Speak for Themselves


[The complete text of "From Privileges to Rights: People Labeled with
Psychiatric Disabilities Speak for Themselves" is available at:]

http://www.ncd.gov/newsroom/publications/2000/privileges.htm

HERE are ten core recommendations from the report's Executive Summary:

http://www.ncd.gov/newsroom/publications/2000/privileges.htm#exe

Core Recommendations

...NCD has developed 10 core recommendations in this report. These
policy recommendations should be viewed from the context of the larger
report, which follows. These deeply held core beliefs form, however, a
dynamic backdrop to highlight the human and civil rights of people who
have experienced the mental health system, people who should be viewed
as the true experts on their experiences, beliefs, and values, which
should be used as a guiding force for changing public policy related
to these issues in America.

1. Laws that allow the use of involuntary treatments such as forced
drugging and inpatient and outpatient commitment should be viewed as
inherently suspect, because they are incompatible with the principle
of self-determination. Public policy needs to move in the direction of
a totally voluntary community-based mental health system that
safeguards human dignity and respects individual autonomy.

2. People labeled with psychiatric disabilities should have a major
role in the direction and control of programs and services designed
for their benefit. This central role must be played by people labeled
with psychiatric disabilities themselves, and should not be confused
with the roles that family members, professional advocates, and others
often play when "consumer" input is sought.

3. Mental health treatment should be about healing, not punishment.
Accordingly, the use of aversive treatments, including physical and
chemical restraints, seclusion, and similar techniques that restrict
freedom of movement, should be banned. Also, public policy should move
toward the elimination of electro-convulsive therapy and psycho
surgery as unproven and inherently inhumane procedures. Effective
humane alternatives to these techniques exist now and should be
promoted.

4. Federal research and demonstration resources should place a higher
priority on the development of culturally appropriate alternatives to
the medical and biochemical approaches to treatment of people labeled
with psychiatric disabilities, including self-help, peer support, and
other consumer/survivor-driven alternatives to the traditional mental
health system.

5. Eligibility for services in the community should never be
contingent on participation in treatment programs. People labeled with
psychiatric disabilities should be able to select from a menu of
independently available services and programs, including mental health
services, housing, vocational training, and job placement, and should
be free to reject any service or program. Moreover, in part in
response to the Supreme Court's decision in Olmstead v. L C., State and
federal governments should work with people labeled with psychiatric
disabilities and others receiving publicly-funded care in institutions
to expand culturally appropriate home- and community-based supports so
that people are able to leave institutional care and, if they choose,
access an effective, flexible, consumer/survivor-driven system of
supports and services in the community.

6. Employment and training and vocational rehabilitation programs must
account for the wide range of abilities, skills, knowledge, and
experience of people labeled with psychiatric disabilities by
administering programs that are highly individualized and responsive
to the abilities, preferences, and personal goals of program
participants.

7. Federal income support programs like Supplemental Security Income
and Social Security Disability Insurance should provide flexible and
work-friendly support options so that people with episodic or
unpredictable disabilities are not required to participate in the
current "all or nothing" federal disability benefit system, often at
the expense of pursuing their employment goals.

8. To assure that parity laws do not make it easier to force people
into accepting "treatments" they do not want, it is critical that
these laws define parity only in terms of voluntary treatments and
services.

9. Government civil rights enforcement agencies and publicly-funded
advocacy organizations should work more closely together and with
adequate funding to implement effectively critical existing laws like
the Americans with Disabilities Act, Fair Housing Act, Civil Rights of
Institutionalized Persons Act, Protection and Advocacy for Individuals
with Mental Illness Act, and Individuals with Disabilities Education
Act, giving people labeled with psychiatric disabilities a central
role in setting the priorities for enforcement and implementation of
these laws.

10. Federal, state, and local governments, including education, health
care, social services, juvenile justice, and civil rights enforcement
agencies, must work together to reduce the placement of children and
young adults with disabilities, particularly those labeled seriously
emotionally disturbed, in correctional facilities and other segregated
settings. These placements are often harmful, inconsistent with the
federally-protected right to a free and appropriate public education,
and unnecessary if timely, coordinated, family-centered supports and
services are made available in mainstream settings.

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