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In December 2020, the Parliamentary Joint Committee on Human Rights (JCHR) reported that the level of interference with human rights was, for most people, “the greatest they will have experienced in a lifetime.” The impact of the pandemic on human rights has been worse for certain people in society.
Evidence is now emerging that mental health and human rights have been neglected during the pandemic. In April 2021, the European Commissioner for Human Rights said there is an urgent need to focus on human rights, and to reform mental health services and support.
This Insight looks at evidence of the impact of the pandemic on mental health and human rights and how international organisations have responded.
International human rights obligations
The UK has signed several treaties placing obligations on the Government to protect and promote the human rights of all citizens. These include international treaties such as the Universal Declaration of Human Rights and regional treaties, such as the European Convention on Human Rights. European Convention rights are enforceable in UK courts through the Human Rights Act 1998.
These treaties protect a range of important rights, including the rights to life, to liberty, to respect for a private and family life and not to be treated in an inhuman or degrading way. These human rights have been affected by the pandemic across the globe.
A rapid review of international evidence looking at mental distress and human rights abuses during the pandemic, published in the journal Frontiers in Psychiatry, found studies from many countries that demonstrated the risks to mental health and human rights. These ranged from a rise in suicides due to isolation and lockdown, to psychiatric patients in several countries showing higher rates of mental illness and experiencing more physical and verbal abuse.
Updated guidance on human rights during the pandemic
Many international human rights bodies updated their advice for national governments on protecting human rights in responding to Covid-19.
On 6 March 2020, the UN High Commissioner for Human Rights asked governments to put human rights at the centre of their pandemic responses.
UN experts advised governments to “remain steadfast” in maintaining a human rights-based approach to regulation, to “facilitate the emergence of healthy societies with rule of law and human rights protections”.
The UN Special Rapporteur for Disability also warned that, globally, people in psychiatric facilities are in a “grave” situation and need extra protection during the pandemic.
Covid-19 and the effect on mental health in the UK
Hospitals and care homes
A JCHR report in May 2021 on Covid-19 in care homes emphasised how care home visiting restrictions relate to human rights, including the rights to life, liberty and to respect for a private and family life.
In the UK, care homes had much higher death rates during the early stages of the pandemic. Amnesty International reported a “devastating impact” from the restrictions and prolonged isolation on the mental and physical health of residents in care homes in the UK.
In July 2020, The Care Quality Commission (CQC) made similar findings for people in care homes and hospitals who are subject to the Deprivation of Liberty Safeguards in the Mental Capacity Act 2005. The CQC said that care providers found it difficult to balance the lockdown measures with the need to limit restrictions on people’s liberty.
The CQC reported that leave and visits from family/friends were often cancelled during the pandemic for people with severe mental illness detained in psychiatric units. It said that detained patients also sometimes experienced more restrictions than was necessary.
Do not resuscitate orders
The JCHR received “troubling evidence” in its inquiry that DNACPR (Do not attempt cardiopulmonary resuscitation) orders were applied in a disproportionate way to certain patients. These included older people and people with learning disabilities in hospitals and care homes.
In April 2021, a CQC report found a “worrying picture of poor involvement, poor record keeping, and a lack of scrutiny of the decisions being made.” The CQC recommended new measures so that future DNACPR decisions are made “in a safe way that protects people’s human rights.”
Mental health services
There is evidence that mental health needs have not been met during the pandemic, which has worsened rates of illness and inequalities for some people. This can impact on human rights in many ways if people are denied access to mental health care and support.
In July 2020, The King’s Fund surveyed mental health staff. It found the pandemic’s impact included mental health services being unavailable and staff experiencing challenges to providing quality care. These challenges were due to remote working, staff shortages and redeployment, and staff having to deal with rapid changes and lockdown measures.
A Mental Health Foundation survey found that groups that had the poorest mental health pre-lockdown, have had the biggest deterioration during lockdown.
These high-risk groups include people with pre-existing mental health conditions and people with long-term physical and mental disabilities. People in the survey with pre-existing mental health conditions reported suicidal thoughts almost triple those in the general population.
The Government response
The Government responded in December 2020 to the JCHR report. It said it was “mindful of the need to monitor the impact that the measures taken are having on people,” and is “committed to ensuring that local authorities and care providers are supported to meet increased needs resulting from the pandemic”.
The Government said it has been working to support staff across health and social care “to improve knowledge and understanding” on DNACPR orders and to produce public-facing guidance.
Its guidance on care home visiting in England to promote safe visits has also been updated.
On 12 May 2021, the Prime Minister announced an independent public inquiry into the government’s response to the pandemic that will begin in spring 2022.
Domestic abuse and Covid-19: A year into the pandemic, The House of Commons Library.
About the author: Judy Laing is a Professor of Mental Health Law at the University of Bristol Law School and is currently undertaking an academic fellowship in the House of Commons Library.
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