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(January 2022)

Mahomed, F., Stein, MA., Sunkel, C., Restivo, JL. & Patel, V. The Lancet Psychiatry Vol 9, Issue 5, P341-342, May 2022

Abstract:
In September, 2021, our edited volume Mental Health, Human Rights and Legal Capacity was published. 1 The book takes an interdisciplinary approach to engage with evolving debates related to legal capacity in the field of mental health care, documenting perspectives from legal scholars, practitioners, policy makers, advocates, and people with lived experience of mental health conditions from diverse regions worldwide. The volume is intended to stimulate a conversation. Its objective is to document good practices while also recognising that there remain considerable barriers to the implementation of non-coercive models of mental health support, as required by the 2006 UN Convention on the Rights of Persons with Disabilities (CRPD). Ultimately, our aim is to illustrate that ending coercion in mental health care is both necessary and possible, and that supported decision making in community-based mental health settings is the way of the future. Read more …

(2021)

Stein, MA, Mahomed, F, Sunkel, C & Patel, V. (2021). Cambridge: Cambridge University Press.

Abstract:
Since adoption of the Convention on the Rights of Persons with Disabilities and the interpretive General Comment 1, the topic of legal capacity in mental health settings has generated considerable debate in disciplines ranging from law and psychiatry to public health and public policy. With over 180 countries having ratified the Convention, the shifts required in law and clinical practice need to be informed by interdisciplinary and contextually relevant research as well as the views of stakeholders. With an equal emphasis on the Global North and Global South, this volume offers a comprehensive, interdisciplinary analysis of legal capacity in the realm of mental health. Integrating rigorous academic research with perspectives from people with psychosocial disabilities and their caregivers, the authors provide a holistic overview of pertinent issues and suggest avenues for reform. Read more …

(April 2021)

Mahomed, F. & Stein, MA. African Yearbook on Disability Rights Vol 5(2017), 64

Abstract:
Stigma and associated discrimination against persons with psychosocial disabilities constitute a considerable barrier to the realisation of the highest attainable standard of health in South Africa, Africa, and further afield, constituting a significant human rights violation. This situation is evidenced and exacerbated by mental health as a whole remaining under-prioritised in law, policy and resource allocation. States parties to have a duty to address stigma and discrimination through awareness raising and education. Some important commitments have been made in this respect, particularly at the policy level in South Africa. Nevertheless, and as demonstrated by tragic recent events, effective implementation remains lacking. This article lays out the obligations incumbent upon the South African government to address stigma and discrimination on the basis of psychosocial disability as a public health and human rights imperative by examining positive duties incorporated into international instruments and domestic law and policy. It further considers the role of political de-prioritisation of mental health and how this constitutes stigma of a systemic nature, using case law and examples of research and best practice from South Africa, Africa generally, and beyond. We conclude that South Africa is failing to meet its obligations to persons with psychosocial disabilities, and recommend that positive duties be emphasised in potential disability-specific legislation; high-level political commitment and co-ordination is secured for mental health; the CRPD’s independent monitoring requirement is urgently fulfilled; and contextually-relevant interventions are crafted with the active participation of persons with psychosocial disabilities and their representative organisations. Read more …

(December 2020)

Mahomed, F., Bhabha, J., Stein, M A & Puras, D. Harvard Health and Human Rights Journal, 22, 2 (December 2020), 139-154.

Abstract:
A human rights-based approach (HRBA) to health has long been seen as an important way in which to address public health needs in a manner that is equitable and conducive to social justice. Yet the actual content of an HRBA to health remains unspecific, and therefore implementation remains heterogeneous. This situation is even more challenging in the field of mental health, where human rights considerations are particularly complex and have emerged out of a history of myriad violations. Even when research has been conducted into mental health, it has focused predominantly on the Global North, raising questions of contextual and cultural relevance. Accordingly, this study examined the issue from the perspectives of stakeholders in Kenya who consider their work or the services they use to be rights based. It explored the key principles and interventions deemed to constitute an HRBA to mental health care and psychosocial support, the perceived benefits of such approaches, and the main barriers and supports relevant for implementation. The results produced seven key principles and corresponding interventions. Among other things, it highlighted the importance of economic well-being and self-efficacy, as well as the reduction of barriers to implementation, such as stigma and lack of adequate resourcing. Two key tensions were apparent—namely, the un/acceptability of coercion and the role of traditional and faith-based modalities in an HRBA to mental health care and psychosocial support. Read more …

(2020)

Bhabha, J, Giles, W & Mahomed, F. (2020). Cambridge: Cambridge University Press

Abstract:
Policymakers, advocates and scholars have long concentrated on the importance of equal access to primary and secondary education as a foundation for a democratic and just society. Despite the growing importance of higher and specialist education in an increasingly technological and skill-focused global market, tertiary education has attracted much less attention. And yet universities and colleges are epicentres of egregious disparities in access, which impinge on traditionally marginalised communities, such as racial minorities, migrants, indigenous populations and people with disabilities. By drawing attention to this issue and assembling first-rate material from scholars and policymakers across the globe, this book performs an invaluable service for those interested in understanding and fighting a highly significant violation of educational opportunity and social justice. Read more …

(September 2020)

Mahomed, F. (2020). In A Better Future: Higher Education for Marginalized Populations, Bhabha, J, Giles, W & Mahomed, F. (Eds). Cambridge: Cambridge University Press.

Abstract:
Numerous challenges face people living with disabilities in attempting to navigate the higher education (HE) space in South Africa. These include stigma and discrimination, lack of accommodations, lack of appropriate access to services and curriculum and policy oversights, often compounded by racial, gender and class inequalities that are also determinants of access. Even where disability is accommodated for, these accommodations often do not extend to the realm of ‘invisible’ disabilities, namely psychosocial and intellectual disabilities. This chapter considers how structural and systemic factors might militate to exclude people living with psychosocial disabilities from the HE space, particularly in terms of diversity and inclusion policies, and what can be done to address forms of marginalisation. In particular, it examines the accommodations made for people living with psychosocial disabilities in South Africa’s institutions of HE, while also examining the ways in which such accommodations can be supportive factors in retention and completion. Similarly, it considers what role the lack of accommodations might play in marginalising people living with psychosocial disabilities, hindering their participation and potentially adversely affecting outcomes. It also considers best practice in addressing the specific needs of people living with psychosocial disabilities in other HE contexts. Read more …

(June 2020)

Mahomed, F. Harvard Health and Human Rights Journal 2020 Jun; 22(1):35-49

Abstract:
Throughout the world, mental health remains a neglected priority, low on the agenda of policy makers and funders at the national and international levels. While this is shifting somewhat, there remains a considerable need to address the underprioritization of mental health and well-being, perhaps even more so in the wake of the COVID-19 pandemic. However, given the history of mental health interventions-which have overemphasized the biomedical model and have thus resulted in coercion, denial of life in the community, and unnecessary pathologization of human experience-there is also a need to ensure that increased funding does not simply replicate these mistakes. This is particularly true in the current landscape, where efforts to “scale up” mental health and to reduce “treatment gaps” are gaining momentum and where post-pandemic responses are still being formulated. As the potential for global mechanisms for funding mental health increases, national and international funders should look to practices that are rights affirming and contextually relevant. In this paper, I explore the current landscape of mental health financing, in terms of both national resource allocation and development assistance. I then outline the momentum in global mental health that is likely to materialize through increased funding, before considering ways in which that funding might be utilized in a manner that promotes human rights. Read more …