A perfect storm: Patients, psychiatrists and the pandemic

By Prof Judy Laing, Professor of Mental Health Law, Rights and Policy (University of Bristol Law School)

Mental Health Awareness week is an important time to reflect on how the Covid-19 pandemic is generating a global crisis in mental health. Earlier this month, the United Nations published a policy brief warning that:  ‘Although the Covid crisis is, in the first instance, a physical health crisis, is has the seeds of a major mental health crisis as well.

Stringent lockdown measures have increased social isolation, and for many, this is creating huge psychological distress. That is further impacted by the fear of infection, death and losing relatives and close friends to the virus. The state of the economy is creating additional anxiety and stress for those who have lost or are at risk of losing their income and livelihoods. Professor David Gunnell (a colleague at the University of Bristol who researches on suicide and self-harm) has highlighted with others in The Lancet  that the pandemic will ‘leave many people vulnerable to mental health problems and suicidal behaviour, and increased risks of suicide’. Taking action now to prevent the risk of suicide is therefore imperative. And the United Nations policy brief also urges national governments to take positive action to ensure widespread availability of mental health support, as well as building mental health services for the future to promote recovery from the pandemic. (more…)

Mental disability and voting rights: Bridging the knowledge and uptake gap

By Prof Judy Laing, Professor of Mental Health law, Rights and Policy (University of Bristol Law School)

As the general election approaches and you consider whether to use your vote, spare a thought for the thousands of people who are detained in psychiatric hospitals or living in residential care/nursing homes, and who may not even realise that they are entitled to vote, or be given the opportunity to do so.

Government statistics suggest that there were 21,439 people reported as being subject to compulsory detention under the Mental Health Act 1983 on 31st March 2018, and over three quarters of these people were being detained in hospital in England.[1] The majority of these detained patients have the same right to vote as the general population, but they are one of the most disenfranchised groups in society.  Surveys have found that psychiatric in-patient uptake and knowledge of voting rights is generally poor. For example, a study on the general election in 2010 found that eligible psychiatric in-patients were half as likely to register as the general population; half as likely to vote if registered, and patients who had been in hospital for longer periods were particularly affected.[2] Moreover, research also suggests that knowledge of patients’ voting rights amongst mental health professionals could be improved.[3] (more…)

Promoting the next generation of health law scholarship

By Prof John Coggon and Prof Judy Laing (Bristol University Law School)

In October 2017, we were proud and honoured to mark the launch of the Centre for Health, Law, and Society (CHLS) in the University of Bristol Law School. The Centre is founded on ambitious aims to push the boundaries of scholarship in health law: expand its methods and approaches; broaden its practical reach and points of focus; enhance its place in shaping education; and increase its engagement with, relevance to, and impacts on people, organisations, regulators, and policy-makers across society.

Our launch event allowed a showcase of the breadth of scholarly interest and inquiry within CHLS, as well as an opportunity to hear presentations from leading figures in health, law, and associated disciplines. We start from a basic premise that the value and significance of health requires understandings from ranging disciplinary perspectives, looking across social sectors and actors. We are interested in the roles served by law to protect and promote rights, achieve greater social justice, and to ensure that health and other fundamental values are secured fairly for all.

Since the time of our launch, CHLS has gone from strength to strength. Our community of students, academics and collaborators continues to grow. And we are delighted in March 2019 to publish a Special Issue of the Northern Ireland Legal Quarterly (NILQ), which shows well the depth, range and reach of our ambitions. The Special Issue comprises contributions from 11 of CHLS’ members, as well as from colleagues from other universities. They represent legal scholarship that engages with ethical considerations and social justice, history, human rights, philosophy, politics and social sciences. They approach questions spanning from very individualised rights, to population- and systems-level analyses. (more…)

Is mental health finally emerging from the shadows into light?

By Dr Judy Laing, Reader in Law and Co-Director of the Centre for Health, Law, and Society (University of Bristol Law School).

Mental Health Awareness Week (14-20th May) is a good opportunity for us to reflect on how far mental health has emerged from the shadows over the last decade. For too long, mental health has been neglected in England and Wales, and this is particularly true for our main political parties, where up until quite recently, mental health has rarely featured in pre-election manifestos. There are now positive signs that this is changing and the nation’s mental health is now firmly on the political agenda.

As the King’s Fund identified in a report in 2015, mental health has finally become a political priority for the major political parties. We saw evidence of this in Theresa May’s Conservative party conference speech in October 2017, as she expressed her desire to tackle the injustice and stigma associated with mental health. This was accompanied by a government pledge to direct additional resources to frontline mental health services and staff. This rhetorical commitment to prioritise mental health is welcome and long overdue, but of course, it must be followed by clear action on the ground in terms of additional staff, services and support, if we are going to witness a radical change in the reality of life for the 1 in four of us who will suffer from a mental health problem each year. (more…)

Working together to combat global health inequalities

By Prof John Coggon, Professor of Law, and Dr Judy Laing, Reader in Law, co-Directors of the Centre for Health, Law and Society (University of Bristol Law School).

The World Health Organization (WHO) celebrated its 70th anniversary last month, on 7th April 2018, which is World Health Day. The WHO was established in 1948 and one of its founding principles provides that:

the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.

The WHO has achieved a considerable amount in that time by focusing on many of the key challenges to reducing global health inequalities. Some of the most recent challenges faced by the WHO are the rise in drug resistance across the globe, as well as the threat of global pandemics, as witnessed with the Ebola virus outbreak in West Africa in 2014, and the burdens of noncommunicable disease. International organisations such as the WHO have a crucial role to play in tackling these threats to our health fairly and effectively, but it cannot achieve change alone. The WHO must do so in partnership with national governments and other key actors. Within these agendas, there are crucial roles for law and governance as levers to help create the conditions in which people can enjoy good physical and mental health.

One of the world’s leading global health law scholars, and one such key actor and WHO collaborator, Professor Larry Gostin, visited the Centre for Health, Law, and Society (CHLS) at the University of Bristol in April 2018 as a Benjamin Meaker Visiting Professor. He came to talk about his collaborations with the WHO, and to explore some of the key global health challenges with staff and students from across and beyond the university. A key focus throughout his visit was the ways that we can and should link scholarship with activism, policy, and practice: a question at the heart of the mission of CHLS. (more…)

It’s time for change: World Mental Health Day 2016

By Dr Judy Laing, Reader in Law (University of Bristol Law School).

world-mental-health-dayToday is World Mental Health Day and time for us to spare a thought for the millions of people around the world suffering from mental health problems. The World Health Organization (WHO) estimates that one in four people in the world will be affected by mental/neurological disorders at some point in their lives. Approximately 450 million people in the world are suffering from these conditions at any one time. This means that mental disorder is among the leading causes of ill-health and disability worldwide.

The WHO has urged governments to move away from large mental institutions and towards health care in the community. Governments must also ensure that mental health care is well integrated into the general health care system. Whilst many Western governments have adopted this de-institutionalisation approach, treatment facilities and standards in many countries, especially in the developing world, are still woefully inadequate. Indeed, the WHO reports that more than 40% of countries have no mental health policy and a quarter of countries don’t even have any form of mental health legislation or regulation of mental health care. Added to this is the troubling fact that mental health services across the globe are continually under-funded: 33% of countries spend less than 1% of their total health budgets on mental health care/services. (more…)

Time to listen: A spotlight on mental health

By Dr Judy Laing, Reader in Law (University of Bristol Law School).*

Recent research indicates that a large percentage mental health awareness week hp-handsof patients living with severe mental health problems do not feel actively involved in their treatment plans. In this blog, Dr. Judy Laing outlines how this runs contrary to basic human rights principles and how it’s time that patients’ rights and voices are put firmly at the centre of all decision-making about their care, treatment and admission to hospital. (more…)