International, regional and domestic human rights comprise laws which safeguard entitlements owned by everyone by dint of their existence. Inevitably, it is the rights of the disempowered rather than the strong that most need protection - among whose ranks exists none more important globally than people with a mental disorder. The book's editors claim that the disciplines of human rights and mental health have emerged as converging fields of research and practice that intersect in multiple and complex ways. With what success does this volume chronicle this nexus?
This textbook is a tour de force in its ambition and achievement. Into its four primary sections - conceptual issues, psychiatry and abuses, vulnerable groups, and protection of mental health - are crammed 38 chapters written by almost 100 leaders in the field of psychiatry, behavioural sciences, ethics, philosophy and human rights. Each chapter comprises a referenced exposition focused on a different aspect of either human rights or of psychiatry, and of their mutual relationship.
The multiplicity of chapters reflects the heterogeneity of injustices perpetrated. Inevitably, because of the interlinking nature of related issues within human rights, and within psychiatry, some of the subject matter of one chapter can overlap with content from another. Yet this never creates a sense of repetition; rather, the fresh angle provided by an alternative perspective or author group illuminates understanding of often conceptually complex issues.
The book is impressively comprehensive, demonstrates appropriately rigorous scholarship, and yet remains lucid and interesting. I have learnt a great deal from it, not least that the scale of the historically cumulative crime committed against people with a mental disorder amounts notionally, if not yet jurisprudentially, to a crime against humanity. Although the United Nations Convention on the Rights of Persons with Disabilities came into force only 5 years ago, the binding legal principles applicable to the whole human race were set in stone by 1976.
It feels churlish to criticise this outstanding book, yet, despite an excellent chapter on justice promotion and preventing human rights violations, I found no comment on the nature and magnitude of the cultural change needed to end the discrimination inherent in every violation of human rights. That doctors tend to perceive patients in relation to their illnesses is axiomatic and tolerated. But for discrimination in medical practice to end, doctors must perceive each patient primarily as a rights holder who has a health problem.
This textbook should appear in every medical library and on every psychiatrist's bookshelf, and representative content should be incorporated into the curricula and examinations of medical students and trainee psychiatrists.
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