Human Rights and psychiatry (Part 2 of 2): Who speaks for the chained and incarcerated?Human Rights and psychiatry (Part 2 of 2): Who speaks for the chained and incarcerated?
All In The Mind
Chained in a concrete cell, involuntarily medicated, and isolated. Leading psychiatrist Vikram Patel has amassed a series of shocking photos from asylum settings around the globe -- some taken by 'inmates'. He's challenging his own profession to take action. And, the new Convention on the Rights of Persons with Disabilities. Will it make a difference? In a historic process, self-identified 'psychiatric survivors' have been closely involved in its development.
30:14•15 Dec 2007
Chains, Consent and Care: Psychiatry on Trial for Human Rights
Episode Overview
- People in psychiatric settings worldwide can face chaining, isolation and degrading conditions that resemble prisons rather than hospitals.
- The UN Convention on the Rights of Persons with Disabilities asserts that people with disabilities have legal capacity on an equal basis with others.
- Survivors like Tina Minkiewicz argue that forced drugging and involuntary treatment can cause extreme suffering and feel like repression or torture.
- Supported decision-making is proposed as an alternative to guardianship, allowing people to receive help without losing autonomy.
- Vikram Patel calls for psychiatrists to balance individual clinical work with broader advocacy and system reform, especially in low-resource countries.
“"Without legal capacity, you don't really have anything."”
Curious how psychiatry, human rights law and lived experience collide when people lose their basic freedoms? This episode of All In The Mind looks squarely at that uncomfortable question. Journalist and host Natasha Mitchell brings together leading psychiatrist Professor Vikram Patel, legal scholar Professor Amit Adanda, and lawyer–activist Tina Minkiewicz, who all question what happens when people in distress are chained, locked up or forcibly medicated.
Patel shares confronting images from institutions worldwide, describing one man "chained and he's naked" in a so‑called hospital that "really reminds you of a prison cell". He argues that without compassion or evidence-based care, facilities become places of custody rather than healing. Adanda and Minkiewicz unpack the new UN Convention on the Rights of Persons with Disabilities and what it might mean for anyone subjected to involuntary treatment.
Tina draws on her own history of being locked up and forced to take drugs, saying, "I wasn't crazy to think that this is terrorism against me or repression." Together they explain why legal capacity is central: without the right to make decisions, court protections can become empty, and forced interventions may resemble abuse or even torture.
The conversation also introduces the idea of "supported decision-making" as an alternative to guardianship, asking whether people can be offered help to decide, without someone else taking over their lives. Patel then turns to the brutal arithmetic of global mental health, comparing the tiny number of psychiatrists in India with far richer countries, and suggesting a new role for the profession that balances specialist care with wider community support.
Anyone interested in mental health ethics, coercion in care, or disability rights will find plenty to think about here. It might leave you wondering: who is speaking for those chained, sedated and silenced—and what part could you play in changing that?
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