Rights of people with mental disorders: Realities in healthcare facilities in Tunisia.

Abstract

Mental disorders have been associated worldwide with human rights' violations. Controversially, many occur in mental health facilities. This work aimed to assess the rights of people with mental disorders in healthcare facilities in Tunisia. A cross-sectional study, using the World Health Organization (WHO) quality-rights toolkit, assessed the human rights levels of achievement in Elrazi Hospital, the only psychiatric hospital in Tunisia, in comparison with the National Institute of Nutrition (NIN). The framework was the Convention on the Rights of Persons with Disabilities (CRPD). The assessment was carried through observation, documentation review, and interviews with service users, staff, and family members. The sample was composed of 113 interviewees. In Elrazi Hospital, three out of the five evaluated rights were assessed as only initiated: the right to an adequate standard of living, to exercise legal capacity and to be free from inhuman treatment. By comparison, these rights were partially achieved in the NIN. The right to enjoyment of the highest attainable standard of health was partially achieved and the right to live independently and to be included in the community was not even initiated. These last two rights were at the same level of achievement in the NIN. Significant improvements are needed to adapt the practice in Elrazi Hospital to comply with human rights, especially since the achievement level of these rights is lower than in a non-psychiatric hospital. Our study emphasizes the importance of spreading the CRPD as a standardized framework.