This petiton is about your right to make decisions about your own body and treatment — even during mental health challenges.

 

Did you know that under current South African law, a person diagnosed with a mental health condition can be:

• Hospitalised without consent;
• Given treatment against their will;
• Declared unable to make their own decisions;
• Deprived of their full legal capacity;

This does not only apply to people with intellectual disabilities or severe mental illnesses.
The law applies to anyone diagnosed with a mental health condition -  including people experiencing depression, anxiety, trauma, burnout, temporary stress-related conditions, postpartum depression, etc.

South Africa signed the UN Convention on the Rights of Persons with Disabilities in 2007. That Convention says people with disabilities — including psychosocial disabilities, light or severe or anyone diagnosed with a mental health condition — have the right to:

✔ Make their own decisions;
✔ Refuse treatment (this is part of what is known as “Informed Consent” which includes: being fully informed about all side effects of medications; being informed about alternatives to medications, and being able to exercise the right to refuse treatment); 
✔ Receive support instead of being replaced in decision-making;
✔ Be free from discrimination;

But our Mental Health Care Act has not yet been updated to fully reflect those rights.

Therefore, this petition seeks to align South African law with constitutional and international human rights standards.

• This petiton supports your right to choose it freely.                                     
• It is not against medical science.
• It is about legal capacity and consent.               
• It supports voluntary care.
• It promotes advance directives (which many responsible patients would welcome).

If you voluntarily take psychiatric medication, this petition supports the legal protection of your autonomy.

Mental health care should be compassionate — and rights-respecting.

This is about autonomy.
This is about equality.
This is about protecting everyone’s rights.

Please read and consider signing.

 

IMPORTANT: If this is a new topic for you and you would like to learn more, you can find additional information by watching this video: https://cchr.co.za/videos/#prescription-for-violence 

 

PETITION:

URGENT AMENDMENT OF THE MENTAL HEALTH CARE ACT 17 OF 2002 TO ENSURE COMPLIANCE WITH THE CONSTITUTION AND THE UN CONVENTION ON THE RIGHTS OF PERSONS WITH DISABILITIES (CRPD), PRIORITISING DIGNITY, EQUALITY, FREEDOM AND CHOICE. 

 

Honourable Minister,

We, the undersigned, comprising concerned citizens, advocacy organisations, mental health care users, and allies of the disability rights movement, respectfully submit this petition in terms of Section 17 of the Constitution of the Republic of South Africa, 1996, to draw urgent attention to critical shortcomings in the Mental Health Care Act 17 of 2002 (as amended) and to call for immediate and meaningful legislative reform.

Background:

South Africa ratified the United Nations Convention on the Rights of Persons with Disabilities (CRPD) in 2007, committing itself to upholding the Convention’s core principles, including equality, autonomy, dignity, and freedom from discrimination for persons with disabilities, including those with psychosocial and intellectual disabilities. Notwithstanding this commendable commitment, the current Mental Health Care Act remains inconsistent with the CRPD in key respects, as repeatedly noted by the CRPD Committee in its 2018 Concluding Observations and other human rights bodies.

It is also noteworthy that the Department of Women, Youth and Persons with Disabilities (DWYPD), together with the Department of Planning, Monitoring and Evaluation (DPME), has undertaken several reviews of progress in implementing the White Paper on the Rights of Persons with Disabilities (WPRPD). The Fifth Annual Progress Report (2020–2021) and the subsequent 2023 national evaluation both reflect a growing awareness across sectors of the need for more consistent integration of disability rights into planning, budgeting and service delivery frameworks. These reports identify several opportunities for strengthening coordination, enhancing accountability mechanisms, and accelerating the pace at which inclusive and rights-based practices—particularly in relation to legal capacity, autonomy, and supported decision-making—are embedded in national systems. The findings affirm the importance of aligning sectoral legislation, such as the Mental Health Care Act, with both the CRPD and the principles of the White Paper, in order to ensure a coherent and unified approach to realising the rights of persons with disabilities. Unfortunately, no real progress towards implementing the reforms set forth by the UNCRPD has materialised to date.  Despite this evaluative groundwork, the legislative and policy shift required by the CRPD—particularly the prohibition of coercive practices—has yet to be meaningfully implemented.

 

Evolving Global Standards and Professional Consensus

The global landscape of mental health care is undergoing a critical shift. The World Psychiatric Association (WPA), in its 2020 Position Statement and Call to Action: Implementing Alternatives to Coercion, has formally recognised the urgency of reducing and ultimately eliminating coercive practices in mental health systems. The WPA acknowledges that “these rights have been set out most recently in the UN Convention on the Rights of Persons with Disabilities (2006) as they apply specifically to people with disabilities, including those with psychosocial disabilities.” It further notes that the justification for coercive interventions remains “highly contested” and that improving the quality of mental health care must involve a transition toward non-coercive, rights-based practices. Importantly, the WPA calls for urgent implementation of alternatives to coercion across low-, middle-, and high-income countries alike. This Position Statement provides strong support for law and policy reform that enables mental health care systems to align with CRPD standards while remaining responsive to local contexts and clinical realities. The 2023 WHO–OHCHR guidance further affirms that legal frameworks must abolish substitute decision-making and involuntary treatment regimes in favour of supported decision-making models. South Africa’s current approach still reflects outdated paradigms that urgently require reform.

Core Issues Identified:

1.      Substitute Decision-Making: The Act continues to permit substitute decision-making (via assisted and involuntary care regimes) that enables third parties to make decisions on behalf of persons deemed “incapable” of informed consent (Sections 26 and 32 of the Act). This undermines the CRPD’s principle of equal legal capacity under Article 12, which requires that all persons with disabilities retain legal capacity at all times and are supported—not replaced—in exercising it.

Additionally, this practice conflicts with Section 9 of the Constitution (equality clause) and Section 33 (the right to fair administrative action).

2.      Involuntary Admission and Treatment: The Act allows for involuntary hospitalisation and treatment of persons with psychosocial disabilities, without their consent and sometimes against their expressed wishes. (refer to Sections 33–40 of the Mental Health Care Act). The CRPD Committee has made it clear (Articles 14 and 25) that deprivation of liberty and forced medical treatment based on disability status is discriminatory and violates international law.

                 This also raises concerns under Section 12(1)(a) of the Constitution, which guarantees freedom and security of the person, including the right not to be deprived of freedom arbitrarily.

3.      Lack of Supported Decision-Making Framework: The Act provides no formal mechanisms for supported decision-making (e.g., advance directives, peer-supported consent), leaving persons with psychosocial disabilities without the legal tools to assert their rights and preferences meaningfully. , contrary to Section 10 of the Constitution (the right to dignity).

4.      Failure to Fully Implement Community-Based Alternatives: Despite policy pronouncements, the Act still favours institutional responses and lacks robust provisions to realise the CRPD’s mandate for community-based, voluntary, and rights-based mental health care services. under Section 27 of the Constitution

5.      Failure to protect against abuse: Article 15 raises concerns about the existing abuse and/or degrading treatment in institutions despite Section 11 of the Act. This indicates a lack of oversight and/or accountability for taking adequate steps to prevent such abuse.

We acknowledge the Department’s policy efforts and public statements recognising these challenges. However, urgent legislative action is required to comply fully with the CRPD and honour South Africa’s international human rights obligations.

 

Petitioned Reforms:

We hereby call on the Minister of Health to take the following immediate and concrete legislative steps:

1.      Abolish Substitute Decision-Making:

Repeal all provisions in the Mental Health Care Act that allow for third-party or substitute decision-making regarding mental health treatment (notably Sections 26 and 32).

2.      Enact explicit provisions confirming that persons with disabilities retain full legal capacity at all times, regardless of mental health status or perceived capacity. , in alignment with CRPD Article 12 and Section 9 of the Constitution.

3.      End Involuntary Treatment and Admission:

·        Amend the Act to prohibit any form of involuntary hospitalisation or treatment based on disability or psychosocial diagnosis alone. (Sections 33–40)

·        Align the Act with CRPD Article 14 ensure compliance with Section 12(1)(a) of the Constitution, by ensuring that any deprivation of liberty is based solely on non-discriminatory grounds applicable to all persons, with full due process guarantees.

4.      Introduce Supported Decision-Making:

Provide for legally recognised supported decision-making frameworks, including:

a.      Advance Directives: Enable persons with psychosocial disabilities to pre-state their treatment preferences during periods of wellness.

b.      Support Persons: Allow appointment of personal supporters to assist in decision-making while respecting the person’s will and preferences.

c.      Legal Recognition of Support: Create safeguards to ensure that support is freely chosen, non-coercive, and subject to regular review. thereby fulfilling Section 10 of the Constitution (dignity).

5.      Ensure Genuine Informed Consent:

·        Make explicit that all mental health care interventions, including medication, therapy, and hospital admission, must be based on the free and informed consent of the person concerned, as required by CRPD Article 25(d).

·        Mandate accessible communication and reasonable accommodations to enable full understanding and participation in treatment decisions. in accordance with Section 9 of the Constitution (equality).

6.      Strengthen Community-Based Care Provisions:

·        Amend the Act to set binding targets and deadlines for the development and implementation of comprehensive community-based mental health services.

·        Incorporate provisions that promote deinstitutionalisation and prioritise voluntary, integrated, and culturally appropriate services that empower mental health care users, and support the right to health as per Section 27 of the Constitution.

7.      Enhance Oversight and Accountability:

·        Establish independent monitoring mechanisms, including disability rights experts and persons with lived experience, to oversee compliance with CRPD standards.

·        Ensure that redress mechanisms are accessible to all users whose rights are infringed. Supporting the right to access justice under Section 34 of the Constitution.

https://health-e.org.za/2022/06/07/mental-health-act-section-33-and-34-fall-foul-of-the-constitution/ 

·        Amend Section 30 of the Act to require more thorough and regular reviews and to make the reports available to the health care users, their families and to disability rights experts. 

Conclusion:

South Africa stands at a pivotal moment. We have the opportunity, and obligation, to ensure that our mental health laws reflect the full dignity, rights, and personhood of all South Africans, in keeping with the Constitution and the CRPD. We respectfully request that the Minister prioritise these reforms, table a draft amendment Bill, and publicly commit to a transparent, participatory process, including meaningful consultation with persons with psychosocial disabilities and their representative organisations.

We look forward to your urgent and principled response.

Yours sincerely,

Citizens Commission on Human Rights Africa NPC