Trigger warning: Some readers may find the following story distressing. The article contains details of trauma and mistreatment within the mental health system.
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Mental health patients subjected to "gross human rights violations" - including neglect, violence and forced confinement and isolation - should get an apology, a government-commissioned report has found.
The "Not Before Time" report was produced to provide advice to the Victorian Department of Health on how to address harms caused in the mental health system.
"In order to get to a better mental health system we've really got to confront with what's gone wrong in the past and in the present," report co-author and mental health consultant, Simon Katterl, said.
"We were really conscious in this report that there's huge unmet and unaddressed need here around trauma, and around human rights breaches."
'Open wound'
The report details neglect, compulsory and coercive treatment, police violence, institutionalisation and racism, along with ice baths and lobotomies which have since been discontinued.
While the report is not solely about forced treatment, Mr Katterl said it's "an open wound".
The health department said the report was prompted by the state's royal commission into its mental health system.
"The department established an advisory group, involving people with lived experience and other relevant expertise, to consider options for acknowledging people's experiences," a spokesperson said.
Justice and the chance to share the pain
Among six recommendations, the authors called for a restorative justice process that allows people, family, and carers to share their experiences.
It also recommends a public apology for the suffering people endured.
Other recommendations include individual and collective repatriations and a guarantee preventing past and existing harmful practices from being repeated.
Involuntary mental health treatment was recently flagged at a UN meeting.
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Tying people up is not the answer
Representatives from advocacy group People With Disability Australia (PWDA) attended a UN Convention on the Rights of Persons with Disability summit held at New York.
"We really want to see an abolition of forced treatment, locked wards, and seclusion and restraint. And the ongoing involuntary administration of medications to people," PWDA president Nicole Lee said.
People with Alzheimer's, for example, can get distressed when they don't know where they are in medical settings.
"We're still fighting stigma quite seriously in our country around people with mental illness and psychosocial disability - and more often than not our voices are not believed due to that position of stigma."
Stigma prevents disclosure
Ms Lee said she had been reluctant to disclose her own involuntary medical treatment for an eating disorder over fears it would affect her job prospects, friendship networks and education.
"I was very, very unwell," Ms Lee, a wheelchair user, said.
"But there are so many things that could have been done differently, which would have had a respectful and human rights-based approach to the care that I received, versus what was very dismissive.
"Even unwell people have human rights that need to be protected and upheld," she said of her experience being held under the Victorian Mental Health Act involuntarily.
"It makes it really, really difficult to want to reach out for help, or to ask for help, when that's been your experience of the system because that help comes with some level of harm."
Patients should help decide
Ms Lee would like to see a system that supports independent decision-making taken through a human rights lens.
"Supporting somebody to understand what their decision entails and having a say in their care that they are receiving," she said.
"Even if that care is being received by force, giving that person the ability to have an advocate available to them, who is actually able to support that independent decision-making capacity."
- Support is available for those who may be distressed. Phone Lifeline 13 11 14; 13 YARN 13 92 76; Kids Helpline 1800 551 800; beyondblue 1300 224 636; 1800-RESPECT 1800 737 732.