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Table 2 Summary of Commentaries by the CRPD Committee on Implementation in 19 Countries

From: Is the UN Convention on the Rights of Persons with Disabilities Impacting Mental Health Laws and Policies in High-Income Countries? A Case Study of Implementation in Canada

Country Pop. GDPpc HDI Concerns raised by the CRPD Committee
Argentina 41.45 M $14,715 0.808 • Lack of available resources and services for persons with disabilities
• Legislation on substitute decision-making should be replaced with supported decision-making
• Disparities in implementation at the local level
Australia 23.13 M $67,458 0.933 • Concerned with state’s interpretative declarations to CRPD articles 12, 17 and 18
• No plan to remove substitute decision-making
• Unwarranted use of prison management for non-convicted persons with disabilities
Austria 8.47 M $50,547 0.881 • Different concepts of disability used across laws and policies; some based on the medical model
• Law allows individuals to be confined against their will in psychiatric institutions
• Mental health services should be given with free and informed consent
• Some programs do not cover all disabilities, such as psychosocial disabilities
Azerbaijan 9.42 M $7,812 0.747 • Legislation and policies follow the medical model of disability
• Civil code advances the substitute decision-making process rather than replaces it
• Need better living conditions and end to negative stereotypes for persons with disabilities
Belgium 11.20 M $46,878 0.881 • New law continues to use substitute decision-making
• Laws that contradict the Convention should be repealed
• Mental Health Act enacted in 1990 allows involuntary hospitalization of persons with disabilities
China 1,357 M $6,807 0.719 • Medical model of disability in definition and discourse on the status of persons with disabilities
• System to establish legal guardianship is not compliant with article 12 of the Convention
• Involuntary civil commitment based on actual or perceived impairment should be abolished
Costa Rica 4.87 M $10,185 0.763 • Concerned with descriptions of persons with disabilities and use of the medical model of disability
• Current law does not include the general obligations of the Convention
• Lack of programming and services for persons with disabilities to access loans and court system
Denmark 5.61 M $59,832 0.901 • Lack of disaggregated data and reports of prevailing prejudice
• Current law allows for substitute decision-making
• Reports of coercive treatment of persons admitted to psychiatric institutions
• Absence of disability policy action plans for Faroe Islands and Greenland, both Danish territories
Ecuador 15.74 M $6,003 0.711 • Medical model of disability used and current legislation allows for substitute decision-making
• Data-collection system is not unified, making it difficult to assess disability rights
El Salvador 6.34 M $3,826 0.662 • Current national strategy and framework is not in line with the Convention
• Certain persons with disabilities remain institutionalized
• Lack of information on guardianship and protection of persons with disabilities
Hungary 9.90 M $13,481 0.818 • Insufficient participation of persons with disabilities in the design of relevant legislation
• Decision for institutional care is made by the guardian rather than the person with disabilities
• Law permits a judge to remove the right to vote for those with “limited mental ability”
Mexico 122.3 M $10,307 0.756 • Lack of measures to repeal declarations of legal incompetence
• State legislation authorizes deprivation of liberty of persons with psychosocial disabilities
• Insufficient community mental health services
New Zealand 4.47 M $41,556 0.910 • The Mental Health Act of 1992 is criticized for its lack of human rights principles
• Concerned with state’s lack of specific training for judges regarding the Convention
• Barriers still exist which prevent persons with disabilities from accessing full health services
Paraguay 6.80 M $4,265 0.676 • No mechanisms for consultation with disabled persons’ organizations
• Concerned with the state’s apparent lack of understanding of Article 12 of the Convention
• Lack of information on persons with disabilities who have been institutionalized against their will
Peru 30.38 M $6,662 0.737 • Absence of a coherent and comprehensive strategy that implements the social model of disability
• Substitute decision-making is favoured over supported decision-making
• Deprivation of liberty on the basis of disability including psychosocial disability
South Korea 50.22 M $25,977 0.891 • Welfare of Disabled Persons Act refers to the medical model of disability
• Current system promotes substitute decision-making instead of supported decision-making
• High rates of institutionalization and in some cases without person’s consent
Spain 47.13 M $29,863 0.869 • Current law fails to cover all persons with disabilities
• No measures have been taken to replace substitute decision-making with supported decision-making
• Concerned with the reported abuse of persons with disabilities who are institutionalized
Sweden 9.59 M $60,430 0.898 • The Convention has not been integrated into Swedish law.
• State appointment of administrators is a form of substituted decision-making
• Swedish law allows for a person to be confined against their will in a medical facility
Tunisia 10.89 M $4,317 0.721 • No measures have been taken to replace substitute decision-making with supported decision-making
• Under the current legislation, a disability can constitute a basis for the deprivation of liberty
• Concerned with the state’s lack of clarity on legislation to protect persons with disabilities
  1. All data on population (in millions), GDPpc (gross domestic product per capita in US dollars), and HDI (human development index) were for 2013