The Geneva Prize for Human Rights in Psychiatry

These European philosophers certainly played a key role in disseminating ideas such as freedom and equality and critical thinking and the notion of the Subject but let’s not forget others in all cultures both paved the way and defended these same ideas.

The universality of the idea of Human Rights is encapsulated in the remarkable work published in 1968 by The United Nations Organization for Education (UNESCO) (Reference 1). This work was completed under the direction of the Swiss philosopher Jeanne Hersch. The book was published to mark the 20th anniversary of the Universal Declaration of Human Rights. It is a collection of more than 1100 quotes from texts from all eras, countries, and cultures. The title seems particularly well chosen: “The Right to be a Man”, because this right to be a human is the foundation to humanity.

The United Nations and the World Psychiatric Association

In 1945, the United Nations published a charter protecting human dignity and, in 1948, a declaration of human rights.

Three articles to highlight are:

Article 1: All Human Beings are born free and equal in dignity and rights.
Article 18: Everyone has the right to freedom of thought, conscience and religion.
Article 19: Everyone has the right to freedom of opinion and expression.

With regard specifically to psychiatry, and the rights of the mentally ill, the World Psychiatric Association (WPA) published the Hawaii Declaration in 1976, revised in Vienna in 1983, and in Madrid in 1996. These declarations were replaced in 2020 by the WPA Code of Ethics for Psychiatry.

The WPA Code of Ethics covers clinical practice of Psychiatry, psychiatric Education, research and publication, and public mental health.

Focusing specifically on the Ethics in clinical practice:

Psychiatrists recognize that their primary obligation in the clinical setting is to pursue the wellbeing of their patients, in light of the best available evidence and clinical experience.

Psychiatrists must be sensitive to the needs of families, caregivers and others who are affected by the patient’s disorders.

They recognize that optimal clinical care is rendered through collaboration and should provide education and support.

In addition, they should empower and assist the patient in coping with their disorders and achieving their personal goals.

Focusing on the Ethics in psychiatric public health:

The code states that Psychiatrists must take every opportunity to combat the stigma of psychiatric disorders in the practice of their profession and participate in public health activities that target the stigma of psychiatric disorders. Thus, psychiatrists must promote distributive justice.

In parallel, in the early 21st century, the United Nations also published an essential text in 2006 called The UN Convention on the Rights of Persons with Disability (known as UN-CRPD). This text is arguably the most impactful global advancement in dedication to human rights, as it is at the level of the government, and was signed by numerous countries. Since its inception, there has been a significant discussion and debate on the application of the UN-CRPD to mental health care.

The reason is that UN-CRPD challenges traditional mental health legislations in many ways. Some examples include:

Article 12 states that people with disabilities have equal legal capacity as others.
Article 14 discusses that the existence of disability cannot be ground for deprivation of liberty.
Article 25 promotes social, economic, cultural, civil, and political rights for all disabled citizens including those with mental health disorders.

Together, the UN-CRPD introduces a paradigm shift in the status of a person with disability “from an object of charity, medical treatment and social protection to a subject with rights, capable of claiming those rights, making choices and actively participating in society” (reference 2-3).

It is the first time that the UN General Assembly has adopted a resolution on mental health and explicitly recognized the importance of psychiatry and other mental health professions in providing quality treatments and support to people with psychosocial disabilities.

In recent years, two other documents have been published by the UN

The Sustainable Development Goals and Mental Health in 2015, and the Resolution on Mental Health and Psychosocial Support in 2023. Together, these documents confirm the impressive dedication of the UN to mental health.

The Geneva Prize for Human Rights in Psychiatry

The prize, founded in 1998 on the 50th anniversary of the UN Declaration of Human Rights, is intended to recognize a person, or an organization for exceptional achievements promoting equity and humanity in psychiatric care, reducing discrimination against patients, and encouraging the application of Human Rights and Ethics in Psychiatry. The goals are to reduce negative discrimination and stigma of the mentally ill, to defend the rights of people with mental illness, and to support the application of ethical principles in psychiatric services.

The founding members (reference Geneva prize website) mobilized individuals known for their humanitarian efforts as patrons of the Foundation and invited notables as members of the Jury which was to select laureates. The Council of Foundation is made of up 6 to 7 Members including Psychiatrists, Lawyers, and Representatives of the caregivers and media among others. There is an International Jury which includes the President of the WPA and the President of the Swiss Society of Psychiatry and Psychotherapy (FMPP).

The Foundation assembled funds donated by the State (Canton) of Geneva, the Geneva University Hospitals, the Federation of Swiss Psychiatrists and Psychotherapists, and other philanthropic donors.

In 2008, a close collaboration with the WPA began. Since then, WPA has generously hosted the award ceremony every 3 years.

The Laureates of the Geneva Prize for Human Rights

The first prize was given in 2000 to the Geneva Initiative on Psychiatry (now the Global Initiative on Psychiatry), for its vigorous fight against the abuse of psychiatry for political purposes in the Soviet Union, and for its remarkable success rebuilding the humanitarian dimension of psychiatry in East Europe.

The Congregation del Sagrado Corazon de Jesus was awarded for its achievements in providing help and protection to pregnant women inflicted with mental illness -who were often victims of rape in violent and impoverished settings. The support enabled the women to get treatment and made it possible for their children to thrive.

Dr. Roy McClelland received the prize in recognition of his work on establishing ethical guidelines for mental health services such as confidentiality and respect for patients, leading to the Royal College of Psychiatrists’ Good Practice Guidelines on Confidentiality.

Dr. Jorge Pellegrini was awarded for his engagement with the indigenous population of Argentina who were afflicted with mental illness. He developed a psychiatric service involving the community in a manner that allowed the elimination of hundreds of beds in local mental hospitals.

Dr. Semyon Gluzman was honored for his courageous fight for human rights in Psychiatry. His refusal to participate in the use of psychiatry against political dissidents, as well as his denunciation of abuses in this field earned him a sentence of imprisonment in a work camp and exile. Immediately upon his return to Ukraine, Dr Gluzman worked towards reforming psychiatric treatments and the recognition of the ethical principles that must govern them.

Dr. Naasson Munyandamutsa was recognized for his work in Rwanda building the mental health services, starting with an almost destroyed hospital. He trained people of goodwill and built bridges between people belonging to different ethnic groups. He developed the Rwandese association serving victims of the genocide and established and led the department of psychiatry within the university.

Dr. Ka Sunbaunat was awarded for spearheading the practice of psychiatry in Cambodia even after being mistreated during the Khmer Rouge regime. He led education of staff, creating mental health services and a new generation of people willing to work in mental health care. He is now regarded as the father of Cambodian psychiatry and as a living symbol of resilience.

Dr. Alejandro Paiz was honored for establishing the association Alas pro Salud Mental, a non-governmental organization who fight for the rights of the mentally ill in Guatemala. It is the only NGO working to assist the access of the indigenous rural population to psychiatric care, in a particularly disadvantaged and dangerous environment dominated by poverty and violence and ravaged by a long civil war.

Mr. Grégoire Ahongbonon was awarded for the founding of the Association Saint-Camille-de Lellis, a comprehensive care system in Benin and in West Africa. His work included helping the mentally disturbed people wandering the streets and supporting families and the community elders in the villages. He has worked on family and public awareness to spread the idea that mental illness could be cured, and that people could be treated without chaining them or subjecting them to atrocities.

Mrs. Valentina Hristakeva was awarded for creating an integrated user-focused community service, and a model rights-based mental health network. She has played a pivotal role in the introduction of changes at the Health Act in mental health which guarantees the rights of persons with disabilities and serious mental health problems in Bulgaria. She led policy development and advocacy, as well as implemented anti-stigma and public awareness campaigns for people with mental illness.

Conclusion

The stories of heroes rewarded by the Geneva Prize for Human Rights in Psychiatry impact their communities and the world, and they inspire us that the protection of human rights of people with mental illness is an obligation of all of us regardless our position, profession or nationality.

References

1. Hersch, Jeanne, Ed. (1968) Le droit d’être un homme, Unesco et Payot, Paris et Lausanne.

2. Bartlett, P. (2014) Implementing a paradigm shift: implementing the convention on the rights of persons with disabilities in the context of mental disability law. In: Torture in healthcare settings: reflections on the special rapporteur on Torture’s 2013 thematic report. Centre for Human Rights and Humanitarian Law, American University Washington College of Law, Wahington, pgs. 169-180.

3. Gill, N. and Sartorius, N., Ed. (2024) Mental Health and Human Rights. The challenges of the United Nations Convention on the Rights of Persons with Disabilities to Mental Health Care. Springer.