My body, my rights in all areas of life, including mental health care

Bodily autonomy is the right to govern over our own bodies and have the right to decide, without external coercion or influence. Although a basic concept and fundamental right, it is still highly debated.

Such attack on fundamental rights has meant reduced level protection for individuals, and especially marginalised groups in society such as LGBTQ+ people, racialised communities, women and girls, and people with mental health problems, including psychosocial disabilities. As such, it reinforces the rhetoric and ideology that people’s freedoms and claim over their bodies can be removed, thus preventing people from enjoying their full rights.

The problem is at our doorstep

At a time when we should be working towards achieving a better future for all, we are grappling to have our rights recognised and even observe a reversal of rights protection. Alarmingly, there has been an increased back-pedalling in political support for ending all forms of discrimination, as well as little attention paid to the tireless advocacy against de-institutionalisation and more. This worrying shift is impeding the rights of individuals to personal integrity, self-determination and self-ownership, which will have harrowing consequences in the future.

In Europe and neighbouring regions, countries such as Turkey and Poland progressing in withdrawing from the Istanbul Convention, an internationally agreed framework for zero-tolerance for violence against women and girls and gender-based violence, is a human rights guarantee. Moreover, the United Nations Convention on the Rights of Persons with Disabilities has called on the EU and its member states, as ratifying members to the Convention, to move away from institutional care and towards community-based support. However, over ten years since the Convention came into existence, European countries are still over-reliant on psychiatric institutions as a response to mental ill-health, despite prominent examples of de-institutionalisation for example in Italy.

Supportive decision making should be a reality

Before the COVID-19 pandemic, it was estimated that mental health problems affect about 84 million people across EU countries. According to the Organisation for Economic Co-operation and Development (OECD), one in two people will experience a mental health problem in their lifetime. The active and informed participation of everyone in decisions that affect their lives and rights is consistent with the human rights-based approach in public decision-making processes, and ensures good governance and social accountability. However, suppressed right to bodily autonomy will contribute to the normalised violence, either by dismantling legal protections or by preventing progression towards holistic support systems.

In systems of mental health care, the right to bodily autonomy continues to be contested across Europe. Until today we can find mental health laws that allow for some form of involuntary treatment, including forced institutionalisation, justified when a person is deemed dangerous to themselves or others. And in times of Covid-19, haven’t the last months taught us that exposure to mental distress is something human and understandable, and that periods of discomfort are intrinsically linked to our personal feelings? The call for freedom from coercion in mental health care seems more comprehensible than ever, simply because coercion is not care. Instead smart forms to support an individual’s decision-making, especially in times of personal crisis, should be encouraged.

Unfortunately, the negative trend of finding justification for violating bodily autonomy continues, for example with the so-called draft additional protocol to the Oviedo Convention at the Council of Europe. Such protocol would further cement the idea that others, including mental health professionals, uphold authority over our bodies and subject them to involuntary treatment.

Now, as much as ever, this needs to be a topic of conversation, before the work that has been undertaken by activists, persons with lived experience, local, national and regional organisations for decades, is unravelled.

No one should have a claim to our bodies, except ourselves.