Peru:Human Rights Report Sparks Interest in Mental Health Reform

Mental Disability Rights International (MDRI) and the Association for Human Rights (APRODEH) released a two year study entitled Human Rights & Mental Health in Peru in Lima on September 13, 2004. The report, which details widespread abuses and discrimination against people with mental disabilities-- including people with psychiatric and intellectual disabilities--in Peru, has garnered support from many sectors of Peruvian society for broad-based reform of mental health and social services. Peru's Minister of Health, Pilar Mazzetti, attended the presentation of the report, and offered support for the report's recommendations, noting that a transition to community-based mental health services was necessary.

The report documents a number of serious human rights violations against people with mental disabilities, including: inhuman and degrading treatment in institutions; discrimination in the provision of health and social services; failure to ensure informed consent; and violations of the right to community integration, among others. Investigators attribute these violations to: "near-pervasive discrimination, prejudice, and lack of opportunities for people with mental disabilities; insufficient government financing for mental health and social services; and the historical failure to include people with mental disabilities in services planning." While the report documents a few impressive community-integrated programs, it finds these are primarily privately funded initiatives, and that, "the government has largely failed to take responsibility for the most basic concerns of people with mental disabilities."

The report provides a number of recommendations to the Peruvian government that, if adopted, would help bring Peru's policies and practices into compliance with international human rights norms. While recognizing that increased funding is needed for community-integrated health services and supports, the report offers several low or no-cost recommendations for enforcing the rights people with mental disabilities. These recommendations include:   supporting the creation and training of consumer or family controlled peer-support programs emphasizing non-professional peer support; amending policies barring persons with psychiatric disabilities from rehabilitation centers and other facilities; creating necessary accommodations in community-based trauma counseling programs to include people with psychiatric and developmental disabilities; and   including human rights and disability awareness training as part of the curriculum of health care professionals and others serving people with mental disabilities.

Despite challenges, Human Rights & Mental Health in Peru notes that Peru is a promising country for mental health reform. Peru's Ministry of Health has taken recent steps toward promoting reform, including the publication in January 2004 of "Guidelines for Action in Mental Health." These guidelines promote community-integrated mental health services and the active participation of consumers and family members in services planning and delivery. The Special Congressional Commission to Study Disability has also been a vocal proponent of enforcing the rights of people with mental disabilities, and the Coalition for Human Rights in Health, a consortium of organizations from Peru's vibrant civil society movement, has been actively participating in this process.

The UN Standard Rules on the Equalization of Opportunities for Persons with Disabilities recognize that, "Persons with disabilities are members of society and have the right to remain within their local communities. They should receive the support they need within the ordinary structures of education, health, employment and social services." As the report notes, "With appropriate supports and services, people with mental disabilities around the world have been successfully integrated into the community and live and work in integrated settings." Investigators expressed their sincere hope the report will assist policymakers, service providers, stakeholders, and non-governmental organizations to prevent and eliminate all forms of discrimination against people with disabilities, and transform Peru into a more inclusive society.

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