Well-being as courage: The importance of the social model of disability in exercising the right to mental health.

last 10 October World Mental Health Day was celebrated with the motto that mental health is a universal human right which can be enjoyed by all people without any discrimination. Despite this, it is still a courageous gesture, in a context where disability is considered a tragedy, to heal, to feel – to show – that one comfortably inhabits a body, an identity. We could also say that if you have a mental health problem or disability it is an exercise in resistance to reach a state of comprehensive well-being, as this is counter-intuitive given the lack of understanding and effectiveness of the phenomenon of disability. Is. Enforcing mental health as a right.

Regarding the understanding of disability, it has been understood as a phenomenon characterized by a defect, difference or deficiency, and this has led to stigma and measures to conceal or correct it. From a radical perspective, there is the distribution model in which disability is a punishment or curse, making the subject an object that must be hidden, eliminated, or isolated from society. However, from a biomedical perspective, disability is a biological phenomenon that can be treated through rehabilitation or normalization practices by hiding differences. Similarly, this last approach, although it recognizes the humanity in people with disabilities, does not recognize the status of a subject of law, primarily because the impairment acts as a restriction of rights. Despite the differences in both the models, there is one common aspect and that is that disability is a problem of the individual, not of society.

However, from a legal point of view, and especially the adoption of Convention on the Rights of Persons with Disabilities (CRPD)-In the drafting of which so many workers participated for the first time-, Disability was no longer seen as a defect or a purely biological and individual phenomenon, but was now considered as a special social phenomenon. The problem of disability, in this sense, is not a deficiency of the individual, but a problem of society that does not support this imbalance in the body, in the way of speaking, in communication, in the identity of humanity. People with disabilities should be given equal status. Then, for social models with rights-based approaches disability is no longer a tragedy, because, on the contrary, the tragedy lies in the myth of normality, which transcends disability.

Unfortunately, the persistence of medicalization in our daily practices makes it difficult to unpack social models of disability, because we are accustomed to seeing that problems are individual, when we are inundated with social determinants and tools that shape our behavior. Are. For this reason, living with a disability is already an act of courage, especially when stigma, as a social tool, is internalized in people, encouraging them to embark on the exhausting moral career that Goffman Has explained in his book “Stigma”. Disturbed Identity” (1963).

Regarding the understanding of Mental health as a universal human right, Many complications are also seen. This is because the status of a right implies not only the enjoyment of the right but also its exercise, for example, through necessity. Coverage in mental health benefits that is equal to physical health benefits, access to quality and timely care, promotion of non-discriminatory and pleasant work places for the well-being of workers, etc. However, guarantees of promotion, prevention, protection and recovery in the field of mental health as a universal human right are still far from being effective. Some of the reasons that can be given are, of course, the persistence of medicalization and the weakness of a rights-based approach to these issues.

On the one hand, there is the conviction that mental health is a poor correlate of health problems, when the goal is to equalize treatment and even more so, because mental health problems are not only health problems, but also inter-regional. (Housing, education, work, social development, etc.). This belief has led to few public policies being formulated in the area of ​​mental health and low public budgets being allocated. On the other hand, it is believed that mental health problems are relevant only to the extent that they go unchecked and require coercive intervention through practices still recurring in the Latin American region, such as subjugation. electroconvulsive therapy Involuntary or forced hospitalization into a psychiatric hospital. In this way, mental health prevention and promotion is neglected and is given relevance only when complex interventions are required.

By maintaining asylum statistics such as psychiatric hospitals and not ensuring the protection of the rights of people living in mental health facilities such as homes and protected housing, the recovery and inclusion of people with mental health problems and disabilities in society is also neglected. , The latter because, among other shortcomings, there is no special, independent safety body with sanctioning powers that oversees these devices.

For all the above, if it is already difficult to affirm that the right to mental health is factually exercised and operationalized in practices that allow its exercise, it is even more difficult to maintain That the right to mental health is exercised by people with disabilities. Whose status as a subject of law continues to be questioned.

However, if we take the rights approach and the social model of disability seriously, we must consider that not only is mental health a basic human right for people with disabilities, but capacity rights are also there. Legal, access to justice, informed consent, no hospitalization without or against one’s will, among many other things. But at the same time, the social model also makes us understand that access to comprehensive welfare for any human being should not be restricted by social barriers, as the damage caused could be irreversible.

Adoption of this approach is important for the international human rights system, particularly the Latin American system, which includes treaties such as Inter-American Convention for the Elimination of All Forms of Discrimination against Persons with Disabilities, which establishes such statistics as non-discriminatory in the last paragraph of Article 1 of its Rights such as interference were questioned and restricted. It is hoped that this approach will contribute to relevant regulatory changes both internationally and locally. The above, through the special legislation on mental health, applies in judicial decisions and administrative decisions that affect people with disabilities and mental health users, when they are exposed to the application of involuntary treatment, with their informed consent and consent There is doubt about the ability of Determining advance directives and many other topics included in this approach.

As a final reflection, I would like to point out how important it was in my adolescence, and even now in adulthood, to realize that being able to have a fat body is not a disaster, but a social problem that continues. Is with stigma. Or how much I want to know if you work without rest, if you maintain family relationships that make you feel unhappy, if you feel guilty every time you eat, if you give up places of pleasure. Well-being is hard to achieve if we are. The discourse is dominated by the notion that it is better to vomit, to be very thin, to always be working. The tragedy is not the disability, it is not the body, but it is the unwavering adjustment practices sought overtly or covertly that prevent some degree of well-being. And courage, I believe, is to oppose some of these practices and demand the exercise of human rights as important as mental health.

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