Human Rights and Mental Health: Current Developments in Competence Assessment and Supported Decision-Making

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About this Research Topic

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Background

This Research Topic presents the results of the international and interdisciplinary workshop Human Rights and Mental Health, held at the Institute for Medical Ethics and History of Medicine of the Ruhr University Bochum, Germany, on April 1-5, 2019. The workshop was organized by Matthé Scholten, Sarah Potthoff, Astrid Gieselmann, Jakov Gather and Jochen Vollmann and funded by the German Federal Ministry of Education and Research (grant No. 01GP1884). Matthé Scholten, Sarah Potthoff, Astrid Gieselmann, Jakov Gather contributed significantly to the development of the Research Topic. The Guest Editors will only consider articles from the attendees of this workshop.

The United Nations Convention on the Rights of Persons with Disabilities (CRPD) was adopted by the United Nations General Assembly in 2006 and entered into force in 2008. 180 states parties have ratified the convention to date. The CRPD was motivated by the observation general human rights documents have failed to initiate real change in the rights of persons with disabilities in relation to self-determination, access to health care, education and employment. The CRPD has far-reaching implications for mental health care, and in particular for current practices of informed consent, competence assessment, substitute decision-making, and involuntary commitment and treatment. Because of these profound implications, the CRPD sparked intense debates among academics, policy-makers, service users, mental health professionals and other stakeholders. Especially the interpretation of the CRPD Committee led to controversy. While some consider this radical interpretation the vehicle for the emancipation of service users, others have argued that an implementation of the CRPD along these lines would make mental health service users worse off.

The Research Topic brings together contributions from stakeholders and academics from various disciplines to enrich this sometimes heavily politicized debate with empirical data, legal arguments, ethical analyses and innovative clinical practices. The aim of the CRPD is to promote the autonomy and equality of mental health service users. To facilitate progress and reform, contributions to the Research Topic will critically analyze current practices, propose new legal frameworks and develop innovative clinical practices.

The following questions will be addressed:
· How are competence and mental capacity assessed in current practice?
· Are current criteria for involuntary commitment and treatment consistent with the general aims of the CRPD?
· What are the ethical opportunities and risks of supported decision-making and which legal provisions and
safeguards are needed for its implementation in clinical practice?
· By which methods can the autonomy of service users be enhanced and how can service users be supported
in decision-making?

By addressing these questions, the Research Topic aims to facilitate a constructive debate about the implementation of the CRPD in mental health care and to contribute to improvements in policy and practice.

Keywords: CRPD, mental capacity, competence to consent, supported decision-making, coercion

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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