Mahomed, F., Stein, M. A., Patel, V., & Sunkel, C. (2021). A “Paradigm Shift” in Mental Health Care. In Cambridge University Press eBooks (pp. 1–16). https://doi.org/10.1017/9781108979016.003
Abstract
The passage of the United Nations Convention on the Rights of Persons with Disabilities (CRPD or the Convention) has been hailed as the culmination of a “paradigm shift” from the biomedical model of disability to the social and human rights-oriented model. The CRPD’s assertion of equal recognition before the law applying to all persons with disability, including mental health and psychosocial disability, and thus amounting to universal legal capacity, in Article 12 and in the subsequent General Comment, Number 1 on Article 12 issued by the Committee on the Rights of Persons with Disabilities (CRPD Committee), has been the subject of considerable debate. While many have argued that this is a long overdue protection and a manifestation of nondiscrimination and freedom from coercion on the basis of disability, some have raised concerns based on perceived impracticality or risk. Among the obligations of States parties to the Convention is the mandate to shift from coercion, in the form of substitute decision-making models, to supported decision-making regimes, relying on a “will and preference” standard rather than a “best interests” standard. Even while debate around the exact nature and scope of Article 12 and General Comment 1 continues, efforts to end coercion in mental health and to promote supported decision-making have been gaining momentum in laws, policies, and practices around the world.