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The passage of the United Nations Convention on the Rights of Persons with Disabilities (CRPD or the Convention) has been hailed as the culmination of a “paradigm shift” from the biomedical model of disability to the social and human rights-oriented model. The CRPD’s assertion of equal recognition before the law applying to all persons with disability, including mental health and psychosocial disability, and thus amounting to universal legal capacity, in Article 12 and in the subsequent General Comment, Number 1 on Article 12 issued by the Committee on the Rights of Persons with Disabilities (CRPD Committee), has been the subject of considerable debate. While many have argued that this is a long overdue protection and a manifestation of nondiscrimination and freedom from coercion on the basis of disability, some have raised concerns based on perceived impracticality or risk. Among the obligations of States parties to the Convention is the mandate to shift from coercion, in the form of substitute decision-making models, to supported decision-making regimes, relying on a “will and preference” standard rather than a “best interests” standard. Even while debate around the exact nature and scope of Article 12 and General Comment 1 continues, efforts to end coercion in mental health and to promote supported decision-making have been gaining momentum in laws, policies, and practices around the world.
Since adoption of the Convention on the Rights of Persons with Disabilities and the interpretive General Comment 1, the topic of legal capacity in mental health settings has generated considerable debate in disciplines ranging from law and psychiatry to public health and public policy. With over 180 countries having ratified the Convention, the shifts required in law and clinical practice need to be informed by interdisciplinary and contextually relevant research as well as the views of stakeholders. With an equal emphasis on the Global North and Global South, this volume offers a comprehensive, interdisciplinary analysis of legal capacity in the realm of mental health. Integrating rigorous academic research with perspectives from people with psychosocial disabilities and their caregivers, the authors provide a holistic overview of pertinent issues and suggest avenues for reform.
The importance of primary and secondary education as fundamental drivers of empowerment, achievement and inclusion is widely acknowledged. So is the increasing need for higher education (HE) – education that extends beyond secondary school graduation and that delivers academic, technical or professional instruction – as an essential prerequisite for advancement in contemporary, global society.
Numerous challenges face people living with disabilities in attempting to navigate the higher education (HE) space in South Africa. These include stigma and discrimination, lack of accommodations, lack of appropriate access to services and curriculum and policy oversights, often compounded by racial, gender and class inequalities that are also determinants of access. Even where disability is accommodated for, these accommodations often do not extend to the realm of ‘invisible’ disabilities, namely psychosocial and intellectual disabilities. This chapter considers how structural and systemic factors might militate to exclude people living with psychosocial disabilities from the HE space, particularly in terms of diversity and inclusion policies, and what can be done to address forms of marginalisation. In particular, it examines the accommodations made for people living with psychosocial disabilities in South Africa’s institutions of HE, while also examining the ways in which such accommodations can be supportive factors in retention and completion. Similarly, it considers what role the lack of accommodations might play in marginalising people living with psychosocial disabilities, hindering their participation and potentially adversely affecting outcomes. It also considers best practice in addressing the specific needs of people living with psychosocial disabilities in other HE contexts.