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UNDERSTANDING STIGMA AND DISCRIMINATION IN MENTAL HEALTH, A QUALITYRIGHTS INQUEST (4)

Restricting Rights of Persons with Psychosocial, Intellectual and Cognitive disabilities


Restricted rights or opportunities are limited to those that when not competently completed, will directly or indirectly harm others. It is clear that not being able to properly use a gun may likely lead to physical harm to self or others and that poor hygiene in a restaurant could cause others to become physically ill. In cases like these, the government has a public interest in making sure that the disabilities of some people do not harm others. Exceptions and limitations to rights like these should state that reasonable accommodations need not be provided to a person with a disability if the resources needed for the accommodation would harm given the capabilities of the business. Thus, there is no ambiguity stating that any rightful opportunity that would be hindered by a psychiatric disability and cause public harm may justifiably be restricted because of that disability.


It is noteworthy, however, that the possible harm assumption suggests that any public rights or privileges that do not harm others should not be excluded by law or other institutional policy. For example, access to and enjoyment of most public accommodations (e.g., beaches, theaters, hotels, restaurants) should not be restricted by disability or diminished functioning. Hence, searching for examples of structural discrimination should take into account the public harm concern. A clear definition of the disability on which a person’s right is withheld is necessary.


Principle of Reasonable Accommodation in withholding Rights


The principle of reasonable accommodation is relevant to understanding when rights and privileges can be withheld because of disability. Here, public and private institutions must provide both environmental and interpersonal supports that assist the person with disabilities to function successfully and enjoy the full range of social opportunities. The idea of reasonable accommodation is based on socio-political notions that all human competencies (those of people with disabilities and people without disabilities) represent an interaction of the person’s ability to complete a task and the resources of the environment in which this task occurs. Note, for example, that without many of the technological innovations of the 20th century, few office workers, with or without disabilities, could competently carry out their jobs. In this light, reasonable accommodations are those tools or environmental supports that a person with a disability needs to perform a job. One cannot be considered incompetent if these kinds of accommodations are not provided.


Nonetheless, the duty of ascertaining what constitutes reasonable accommodation can in some way be cumbersome. However, society needs to continuously work to attain the exact nature of these accommodations. Some classifications have emerged that have been mentioned for people with psychiatric disabilities on the job. These include supervision, which can be in the form of having job coaches to provide support and counseling at work; job restructuring, as in reallocating marginal job functions; workplace modifications, e.g. providing room dividers or soundproofing to diminish distractions; and sick time, which refers to permitting the use of accrued paid leave or unpaid leave for psychotherapy.


A tangible provision of reasonable accommodation needs to be considered when examining whether certain public or private rules and regulations represent structural discrimination. The insufficient resources representing (e.g., failure to pass parity or to adequately support public services) will hinder services that provide reasonable accommodations. Without these services and accommodations, the person may remain disabled and more prone to the harm of discrimination.


Having touched on mechanisms to reduce or eliminate structural discrimination with regards to persons with PIC disabilities, we conclude that there is always a need to reinstate rights in instances where they are permissibly restricted. It is this recognition and respect for rights that QualityRights stands for. It is the spirit behind the concept of QualityRights. There should be avenues that seek to ensure that rights or privileges of persons with psychosocial, intellectual, and cognitive disabilities are reinstated when the disability diminishes or as soon as the specific disability is no longer relevant. This assumes not only that adequate definitions and measurement strategies exist for assessing the relevant disability, but also that mechanisms exist for the regular and timely assessment of changes in the disability. At a minimum, some processes must be evident that guarantee speedy assessment to persons with restricted rights who believe that their disability no longer makes them incompetent or harmful.

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