Autism in UN report on mental health / by Erich Kofmel

The United Nations Special Rapporteur on the right to health dedicated his 2017 report to the UN Human Rights Council to mental health. It includes a number of explicit mentions of autism and autistic persons.

"4. [...] Some have cognitive, intellectual and psychosocial disabilities, or are persons with autism who, regardless of self-identification or diagnosis, face barriers in the exercise of their rights on the basis of a real or perceived impairment and are therefore disproportionately exposed to human rights violations in mental health settings. Many may have a diagnosis related to mental health or identify with the term, while others may choose to identify themselves in other ways, including as survivors. [...]

"8. For decades, mental health services have been governed by a reductionist biomedical paradigm that has contributed to the exclusion, neglect, coercion and abuse of people with intellectual, cognitive and psychosocial disabilities, persons with autism and those who deviate from prevailing cultural, social and political norms. Notably, the political abuse of psychiatry remains an issue of serious concern. While mental health services are starved of resources, any scaled-up investment must be shaped by the experiences of the past to ensure that history does not repeat itself. [...]

"55. Adequate mental health services must be made available. In many countries, the limited mental health and social care available is based on a narrow biomedical model and institutionalization. [...] Services must support the rights of people with intellectual, cognitive and psychosocial disabilities and with autism to live independently and be included in the community, rather than being segregated in inappropriate care facilities. [...]

"58. Mental health services [...] must be culturally appropriate and acceptable to persons with intellectual, cognitive or psychosocial disabilities and with autism, adolescents, women, older persons, indigenous persons, minorities, refugees and migrants, and lesbian, gay, bisexual, transgender and intersex persons. Many within those populations are needlessly medicalized and suffer from coercive practices, based on inappropriate and harmful gender stereotypes. [...]

"62. In particular, children and adults with intellectual disabilities and with autism too often suffer from institutionalized approaches and excessively medicalized practices. Institutionalizing and medicating children with autism, based on their impairment, is unacceptable. Autism represents a critical challenge to modern systems of care and support, as medical attempts to 'cure' the condition have often turned out to be harmful, leading to further mental health deterioration of children and adults with the condition. Support for them should not only address their right to health, but their rights to education, employment and living in the community on an equal basis with others. [...]

"91. The Special Rapporteur calls for leadership to confront the global burden of obstacles and embed rights-based mental health innovation in public policy. That includes State champions in international policy efforts, the leadership of professional psychiatry in assessing constructively its approach to the necessity for change, managers of mental health services leading change by example and municipal officials championing grassroots innovation. These champions must work in partnership with their constituents, including persons with intellectual, cognitive and psychosocial disabilities and with autism."

Full text of the report in English:

Also available in French, Spanish, Arabic, Russian, and Chinese:

Unfortunately, in a number of other places where autism should have been mentioned explicitly, it isn't (most importantly, with regard to legislation depriving people of legal capacity). Still, we feel that the mentions of autism are informed by discussions and interactions Autistic Minority International has had with the Special Rapporteur, and autistic self-advocates and allies should be using this report in our ongoing advocacy with the UN and national, regional and local governments.