規約人権委員会事前質問事項意見書

Parallel Report from Japan National Group of Mentally Disabled People

Situations of mental health institutions are excessively bad in every aspect and persons with psychosocial disabilities frequently die in the institutions. Mental health policy is totally incompatible with the Convention on the Rights of Persons with Disabilities. Also, it is insufficient to promote involvement of persons with disabilities in making the policy. First of all, involuntary commitment in mental health institutions based on actual or perceived mental impairments should be abolished.
The number of involuntary admission in mental health institution is growing and there is almost no relief measure against involuntary admission. Obligation of discoverer to report an abuse which provided by the Act on the Prevention of Abuse of Persons with Disabilities and Support for Caregivers doesn’t cover abuses which happen in mental health institutions. Average length of stay in mental health institution tends to be extended, because persons with psychosocial disabilities would not receive enough support service in communities.
Toward solving all these hard situations, We, Japan National Group of Mentally Disabled People, propose following question to contain in the list of issues to the Japanese government.

1. Implementation of the Convention on the Rights of Persons with Disabilities
– Involuntary commitment of persons with disabilities in mental health institutions based on actual or perceived impairments violates the Convention on the Rights of Persons with Disabilities. Please provide information on measures being taken or planned to resolve this violation through closely consulting with and actively involving persons with disabilities.
– Please provide information on discussions process about comprehensive policy related to advocate for persons with psychosocial disabilities
– Please clarify the reason why representative organizations of persons with disabilities aren’t involved in policy making discussion as an organization.

2. Evidences and reasons of that there are many inpatients who stay for long time in mental health institution
– Please provide information on: (a) Number of the beds in general hospitals for mental health and beds in mental hospitals; (b) Average length of stay in general hospitals for mental health and mental hospitals; (c) Number of inpatients who stay over 10 years in mental health institutions; (d) Number of reported involuntary commitment in mental health institutions in the past decade.
– Please clarify: (a) Whether there is a fact that organizations of persons with disabilities point out that long-term hospitalization is a human rights violation; (b) If yes, how is the progress on approaches and results of these approaches to solve the violation; (c) Whether the government has numerical targets of promoting deinstitutionalization of persons who stay for long time in mental health institution.

3. Concrete plan on numerical target and period of time to decrease beds in mental health institution
– Please provide information on concrete plan on numerical target and period of time to establish support service in communities in order to decrease both voluntary and involuntary admission.
– Please clarify that persons with psychosocial disabilities have legal measures against their human rights violation on an equal basis with others in Japan.
– Please provide information on how the government allocate budget for mental health between medical treatment and welfare. Please also clarify what is the percentage of the budget for community services, and what is a ground of the estimation.
– Please provide information on the approaches which being taken or planned as alternative measures which are provided in communities instead of medical services for inpatients. Please also provide information on how many people are deinstitutionalized by the approaches.

4. Situation of abuses in hospitals and school, and its preventive measures
– Please clarify whether the government has data on the number of abuses which happen in mental health institutions. If yes, please provide data on the number in 2014 and 2015.
– Please clarify the reason why staffs of schools and hospitals are under no obligation to report abuse, even though staffs of other welfare facilities are under obligation to report.
– Please clarify the reason why there is no legal relief measure for abuses against persons with psychosocial disabilities.

5. Data on the situations of transportation to mental health institutions
– Please provide information on what is the percentage of that public transportation services are used to transport to mental health institutions.

6. Psychiatric review board
– Please indicate an official document which provides purposes of psychiatric review board.
– Please provide information on implementation status of psychiatric review board and its actual effects.
– Please provide information on the number of claim of discharge to psychiatric review board and the number of acceptance of discharge.
– Please clarify whether the government provides relief measures to appeal against a judgement of psychiatric review board.

7. Situations of restrictions, including physical restraints
– Please clarify whether there is a measure being taken or planned to reduce restrictions, especially physical restraints.
– Please indicate an official document which provides grounds of a restriction. Please also clarify whether the document has been criticized, and if yes, how the government examines it after the criticism.
– Please provide information on: (a) Number of solitary confinement in the past decade; (b) Number of physical restraint in the past decade.