In making these comments, Mijatović recognized the relationship between coercive care, isolation from the community and the stigmatization of people living with psychosocial disabilities (i.e.disabilities arising from the interaction between a person with a mental health condition and their environment).Stigmatization remains a challenge and may ultimately lead to the violation of numerous rights, such as the right to live freely in the community, and the right to make decisions about treatment or support.The underlying belief is that people with psychosocial disabilities lack the intellectual capacity to make decisions for themselves, which can engender a destructive cycle of marginalization and abuse.3 The harmful effects of coercion have led commentators, such as the United Nations' Special Rapporteur on torture and other cruel, inhuman and degrading treatment or punishment, Juan Mendez, and Mijatović to propose that there should be no coercion under any circumstances.2,4 Full realization of the human rights of people with psychosocial disabilities is a general principle of the World Health Organization's (WHO's) Comprehensive mental health action plan 2013-2020.5 With the issue becoming a central concern for policy-makers and practitioners alike, there is a need to consider how this general principle can be operationalized in the context of decision-making.The aims of this paper are to highlight the human rights implications of involuntary mental health treatment and admission, to examine the consequences of this practice, and to explore the operationalization of a rights-oriented approach to decision-making and legal capacity in a range of scenarios.In addition, given that mental health conditions are distributed across a spectrum, and that the paradigm espoused by the United Nations Convention on the Rights of Persons with Disabilities should be incorporated into care and support regimes throughout that spectrum, the paper also considers the legal capacity challenges faced by people with acute conditions because their situation has given rise to the most complex debates among both practitioners and scholars.[6][7][8] Rights affected by involuntary treatmentHistorically, mental health systems have been too reliant on coercion and have tended to deny that people with mental health conditions have the capacity to decide whether to accept or refuse treatment.9 Moreover, a key characteristic of mental health laws around the world has been substitute decisionmaking, whereby the decision of a clinician or another official can legally supersede the preference of an individual if that individual is deemed to be mentally incapacitated.
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