Stop to submit the MHA bill again


Stop to submit the MHA bill again

発信者:山本 眞理 宛先:The Prime Minister Abe

In Japan now the government tries to submit the amendment bill of Act on Mental Health and Welfare for the Mentally Disabled (Act No. 123 of 1950, the last amendment in 2016 hereinafter MHA) for the Diet in January next year. The bill was stopped by the Diet dissolution, but the government will introduce it again. The ruling party won the majority of the election and the bill will easily pass the Diet if it will be submitted.

We call for the urgent action asks to stop submitting the bill to you all.

We strongly against the bill for these reasons;
1 The government flamed up as if psychosocial disability was the cause of mass killing and it submitted the bill as the countermeasure against the crime and to stop such crime never again. (Prime Minister Abe delivered the speech at the Diet on 20 Jan.2017.
It was introduced by prejudice and instigates the discrimination against persons with psychosocial disability that they were dangerous to commit such terrible crimes.

On 26 July 2016, one previous staff of the institution for persons with disability attacked the institution Yamayuri-en and killed 19 persons with disability and injured 26 persons with disability. In February 2016 he sent the letter to the chair of the Diet that declared the plan of attack and said persons with disability should be killed, and then he was coercively hospitalised by the Art. 29 of the MHA from 19 Feb. to 2 Mar. 2016 after the psychiatric exam that reported he was dangerous to others or oneself.
The attack was the hate crime against the persons with disability. But the government established the team in Ministry of health, Labour and Welfare to review the coercive hospitalisation system shortly after the attack on August 2016.
The arrested person as a perpetrator was prosecuted on 24 Feb.2017, after psychiatric exam declared that he had criminal responsibility.

2 The amendment bill of MHA radically changes shift the purpose of mental health service from the patients' own interests to public security, though the government always has explained that the purposes of the MHA and coercive hospitalisation are in patients' own interests. If the bill will pass the Diet and become enacted, the whole mental health system, including services in the community becomes the tool to control and monitor against persons with psychosocial disability. And also the bill infringes on the right to privacy and breach confidentiality of mental health professionals.

The bill includes the new system to make the "support plan" only for the patients who were subjected to the coercive hospitalisation by Art, 29 of MHA. It is the discrimination based on actual or perceived disability. There are many people without disability who are dangerous to others or to oneself, but they are not subject to such treatments and coercive hospitalisation itself. It is discrimination against persons with psychosocial disability.
In the bill, there is the article that before the cancellation of coercive hospitalisation by Article 29 even if the hospitalisation continued , the local governments which ordered the coercive hospitalisation have the obligation to establish the case management team and there is no obligation including a patient concerned.
According to the bill of MHA, the local government has the obligation to establish "the committee to support persons with psychosocial disability in the community ". However, the members of this committee show that its purpose is not really of the support; instead, the members are local health centre staff, a hospital staff, and other service providers and the police, etc... We concerned mostly that between members of this committee, including the police, they share patients’ sensitive private information without their consent.
In this way mental health professionals should breach confidentiality under the amendment bill. Furthermore, the private information of the persons should send to another local government even when they move homes and the term of sharing the information is indefinite. In general mental health professionals are very paternalistic and most of them do not hesitate share clients and patients private information “for their best interest” and recognize it as good practices, even without persons concerned consent and there is an unbalance of power between professionals and users, so most users cannot resist and are subject to their practice with so called consents.
We have already the article to breach confidentiality of psychiatrists in the Act on the Protection of Specially Designated Secrets (Act No. 108 of 2013).
With this information there is the illegal drug addiction and also making the plan by “firm belief”.
And especially making the plan of the crime by “firm belief” is not yet the crime so the police should not and cannot make the intervention so the police sent the defendant in Yamayuri-En attack case to mental health system. And also mental health system should not make the coercive intervention. If the mental health system makes such intervention, psychiatric hospitals become the indefinite detention centres. Psychiatrists should not and cannot correct one’s own belief. If they try to correct it, the whole mental health system becomes security measure and we are afraid that persons labelled with anti-social personality disorder will be subject to coercive hospitalisation and indefinite detention. To send the defendant of Yamayuri-En case to mental health system is the biggest fault and it is not the problem of mental health system.
The monitoring system in the bill makes the community as if it was the ward of a psychiatric hospital or of a prison. Whole daily life will be monitored and controlled by service providers and hospital staffs and the police.
If a person with psychosocial disability disagrees or is unhappy with the monitoring and control, they are subject to refusal of medical treatments or any service, including the disability pension and the social benefit and might become homeless or neglect to die.
Any support or support plan should be by their own will and preference and medical treatments also should be delivered with the free and informed consent by a person concerned.

CRPD requires that the state party should ban the detention of persons with disability based on disability against their will, and also any rehabilitation and medical treatments should be voluntary. CRPD requires also nondiscrimination against person with disability and respect the right of privacy and integrity. MHA itself violates CRPD and the bill of the amendment of MHA violates CRPD.
Please take the urgent action to Japan. 

Summary of JFBA opinion paper (summarised by Mari Yamamoto)