FEMALE_1: >> Hey, Eric. Have you taken these cases to the committee against torture or the Human Rights Committee? Have you gotten any statements that this is a form of torture? Eric Rosenthal: >>Yes, in fact, in Turkey, we documented the practice of something called unmodified ECT, which is electroshock without anesthesia, and it is a horrible experience where you feel the electricity coursing through your body. We found 15,000 people a year being subjected to unmodified ECT. As a result of our work, we got the European Committee for the Prevention of Torture to go in, and they declared it a violation of the torture convention. We were able to get that threshold met just by inviting them in to visit. When we were in Serbia last year, we found many orphanages where children were tied down to beds. We were invited by the UN Special Rapporteur on Torture. As a result of this convention, the UN Special Rapporteur on Torture, a guy by the name of Manfred Nowak, whose job worldwide is to document torture and speak out against it under something called the Convention Against Torture. Invited us in to a panel on human rights and disability. We presented this case of children tied down to beds, and we said, "This is torture." Under the definition of torture, you have to show intent to cause pain for some particular purpose. Many human rights organizations have been hesitant to use the term torture because if you have a medical context in which theoretically, they're there to help the patients, can you say that you're intentionally causing pain for some bad reason when you're saying, you're going to help them out? We went through the definition of torture and we said, "Look, any person who ties a kid down to a bed and leaves them there has to know that they're going to cause enormous pain. Whether it's their intent to do it for the purpose of causing pain or not, it is clear you tie someone down, it hurts. You can claim you're doing it there for medical reasons, but the fact is it's dangerous to leave a kid tied down to a bed. You can't say that that's some lawful purpose or medical necessity. There's a whole doctrine of something called medical necessity. If the doctors have to do it to protect your life, then it's not considered torture." But what we argued was that it was not medical necessity. It was actually dangerous and medically harmful. The UN Special Rapporteur told us, "You're trying too hard. Look at this, it's obviously torture." In the report to the UN General Assembly last year, the Special Rapporteur on Torture called these practices torture, and there's a very extensive report on it now. We've made it over that threshold. There has been this big problem that medical care couldn't be considered torture, and it is now recognized torture is the most extreme human rights violation. When I made this video eight years ago, I referred to it as inhuman integrating treatment. We weren't ready to go over that limit. It just so happens, inhuman integrating treatment is also a human rights violation. It's never permitted under any circumstances. But torture carries with it one more level of international approbation and it carries with it the obligation to prosecute, criminal prosecution. The question is, are those well meaning staff people in the institution subject to criminal prosecution? We argue that if you're going to submit a person to the most extreme pain that any human being can experience, and you're going to leave them there for a lifetime, that there has to be the most strict prohibition, and that it's no longer enough to say, "It's a human rights violation, but we can't do anything about it. It's only going to come to an end when there are consequences." Now, there has never been prosecution for this, but we argue that it has to reach the highest level of prohibition and that it constitutes torture and should be prosecuted. MALE_1: >> To what degree? I'm not talking about dissidence here, but to what degree is institutionalization applied politically against, say, minorities, the poor working class people? Eric Rosenthal: >> That word politically is one of those subjective terms. What's political? The fact of the matter is, you go to an institution, and the people in that institution are the people rejected by society for one reason or another. There are poor people who had no other place to go. There are people who were born there because their parents were in the institution. There are deaf people. There are physically disabled people. There are mentally disabled people. There are little kids who became disabled a result of being there. We've seen gays and lesbians in institutions. Who knows exactly what their personal story was that got them there. I am certain that in any society in which there are no legal protections, and there's this convenient place where you can dump people that you're going to have political institutionalization in the same way that I've talked to many. I was in an institution in Armenia, and there was an American woman from Los Angeles, and she says, "I went to visit my husband in Armenia, and he talked to the doctor and had me institutionalized," and this American woman from Los Angeles is locked up in institution with no due process. Is that political? She has a psychiatric diagnosis that's legitimate. Maybe legitimate, maybe not. But as long as the doctor could say she's mentally ill, she's locked up. I would consider that political. But it's certainly a form of abuse that is open to a broad range of. MALE_1: >> Say, for instance, in Turkey, is that something that's applied more extensively against the Kurdish minority? Eric Rosenthal: >> I don't believe that it's a specific policy in Turkey to take political dissidents and put them in institutions, although, as I'm saying, it obviously could if they wanted to. MALE_2: >> Thank you. In the video, it mentioned that some of the institutions had been closed. My question is, what happens to the people being held in an institution once it's closed? Where do they go? Where do they end up? Eric Rosenthal: >> That is a very interesting question. I'll tell you about the situation in Mexico. After we brought down the ABC News cameras in 2020, did an expose, we also had our Mexico coverage in the New York Times Magazine. ABC News brought its camera in, interviewed the Minister of Health in Mexico, and he pounded his hand on his fist and said, "I am outraged by these abuses, we will not let it continue. This institution will be closed in six months." Well, as you may know, from experience in the United States, it took us 10, 20 years to close our institutions and create meaningful community-based alternatives. We, very often in the United States, pushed reform too quickly and closed institutions when we hadn't created humane, dignified, safe places for people to go. We have an embarrassing and tragic history of patient dumping. As many of you know, from the early 1980s and the late 70s, we had a very serious social problem of many homeless people who had been dumped from psychiatric facilities without the creation of community care. When we published our report, there are some copies of our Mexico report around, we actually said in our report, "Be very careful. Don't close these institutions before you create some safe alternative for them." The Mexican Minister of Health, after the television lights were turned off, came back to us and said, "I've made this promise. What can you do for me? I got to do something. I got to show some change." I was with a guy named Dr. Robert Okin. He and I are both getting an award from the American Psychiatric Association this year, the Human Rights Award. He's an amazingly committed guy who ran the San Francisco Psychiatric Hospital and closed down. He deinstitutionalized Massachusetts. He deinstitutionalized New Hampshire, created some very good programs in San Francisco. He offered to help the Mexican government. We as a human rights organization, need to be able to preserve our independence to monitor human rights, and so we can't get directly involved in service delivery. We stepped back, he stepped forward, volunteered and brought 10 members of his staff from San Francisco, moved into the psychiatric facility, right outside of Mexico facility, a place called Carranza in the state of Hidalgo. I remember, he described how coming in from the airport, he stopped and got a car load full of toilet paper, thinking that at least they can start with that. Arrived at the facility and found that the pipes were 100-years-old and clogged, and the cost of fixing the pipes would be so great that it was just not worth fixing up this institution at all. That's a really key point. People with disabilities have a right to be part of society, and that is one of the key developments that is included in this new UN convention. It's not just the negative right against improper detention. It's not just the negative right about society locking you up. The new UN disability convention is a radical and valuable step forward in that it recognizes the positive right to be part of society. Too many times, mental health reformers have spent so much time and effort, and money fixing up institutions so you get a slightly cleaner way of being segregated from society. In Mexico, with intense government support in six months, they were able to close this highly abusive psychiatric hospital in the six-month window that this Minister of Health had promised and they were able to create group homes in the community. It was about 600, 800. It's in the back of the Mexico report. There's a afterward that describes this process. About maybe 200 or 300 people, a third of the institution, they got into community-based services with care going into the homes. They got emergency services at hospitals. They were able to create a community-based service system for a third of the patients in six months. One third of the patients, sad to say, with more serious medical problems, they just institutionalized in other facilities. They closed down this highly abusive one. Let me say that we did not solve the problem for these one third who are still languishing away in other facilities. Interestingly enough, the last third were moved. What we talked about then, they leveled the institution and they needed new homes for these people. We argued to get them immediately into the community. They said, it's too complicated to do that, and they created these pretty little bungalows out on the grounds of the facility. Unfortunately, this was in a remote field, not in a city, and they created these nice, pretty little houses with a little kitchenette, and they planted flowers in front of them, and they promised this would be temporary until they created community-based homes for these people. They said, "We promise." We said, "We're going to be watching. We're going to be monitoring. Don't stop there." Shortly thereafter, there was a big political change. This is around 2000 when President Fox was elected in Mexico, and the old PRI government of Mexico was kicked out. The activists who had been so strong and fighting with us, many of them got jobs in the government and no longer wanted outsiders looking at what was going on. We stopped scrutinizing and a few years later, we were at a meeting of the Pan American Health Organization, and there up on the screen was the Hidalgo model of community mental health, and these temporary facilities that were supposed to be only there until they could create community facilities were now being touted by Mexico as their model for reform because look how humane it was that these people were living in these nice, pretty bungalows with some flowers out front. That is not the solution that we're looking for. Clearly, life and death abuses have to be ended first. You've got to stop people from living in filth and freezing to death and do immediately what you can do to save their lives. But ultimately, this form of nice, clean segregation is not what we're looking for, and that's very much what the convention is all about, providing opportunities for full community integration. They went halfway, not all the way. MALE_1: >> We have about 10 more minutes. Other questions? Eric Rosenthal: >> I'm going to just take a few minutes to talk about some of the ways that this convention is really revolutionary. It's revolutionary in part, just by putting disability on the agenda. It was ignored. I myself was a bit of a skeptic when this whole thing started. I thought, "Another convention. What's the difference it's going to make? We've got the covenant on civil and political rights. We've got all these other conventions. Is it worth it to put another convention out there?" In theory, the protections are already there under other conventions. But what I have found, it has been amazing. Just the very fact of having a specialized convention on the rights of people with disabilities, all the UN agencies that never thought about disabilities have to go through their checklists and say, "What are we going to do?" I have to say, at the meeting space at the United Nations as we were negotiating this convention, there was one basement level room where we had to do all the negotiations on the convention because it was the only accessible room in the whole building. When we had to have a vote at the very end on the convention, there was no voting facilities, and they had to move to an inaccessible room to vote on the disability convention. The UN is not accessible. I've gone to field offices of the United Nations and International Development organizations. I remember in Kosovo, when I got there at the Ministry of Social Welfare, the disability office was a six floor walk up. The United Nations International Development Organizations need to change the way they do business, and the convention has put the issue on the table. Article 32 also specifically refers to international cooperation. It is embarrassing to say that much international foreign assistance money, including your tax dollars are being used in manners that are discriminatory against people with disability. We work with Senator Harkin and to get some legislation through Congress that requires US foreign assistance to be done in a way that's accessible, but we have not yet accepted the idea that this is binding law and that there is a civil right or a human right to accessible international development money and there are many programs around the world, not only that are inaccessible, but very often perpetuate the problems. Time and time again, foreign assistance agencies see crumbling institutions and instead of acting in a way that's consistent with social policy and human rights of working to provide community integration, what do they do? They rebuild the institution. Orphanages, well meaning people who want to help the orphans? The orphans need families. They need to get out of the institutions. But people send teddy bears. They fix up the facilities. They make nice clean institutions with good medical care, and those kids languish without someone to love them, and many of them become self abusive, like what you've seen. Our foreign assistance agencies need to be made accessible to people with disability, and that obligation now exists under this convention. Whether the United States ratifies this or not, we are now operating in countries that recognize these principles, and we've got to learn to comply. Fortunately, President Obama has said that he's going to sign the convention. It was one of his campaign promises. It's being fast-tracked. There is some support in the Senate. There is some real chance that the United States is going to sign on and hopefully ratify this convention. It is an incredible embarrassment. We, the United States, were one of the great innovators in disability rights. Many of the core disability rights principles, the Americans with Disabilities Act is a model that many countries have used to develop their own laws. The advances that people with disabilities have made have shattered stereotypes throughout society and demonstrated that people with disabilities can be full members of society and have jobs and go to school and have an education, things that we take for granted are radical concepts in much of the world, and the United States is really on the cutting edge, and yet it is a shame that we didn't support the drafting process and we have not yet signed, and it is absolutely essential that we build support for ratification. I will mention that there are a few areas of the convention that are actually go a few steps beyond US law and are really going to shake things up. Article 12 on the issue of legal competence. This gets a little bit technical, but the idea that a person with a mental disability can make choices about their own lives, many laws around the world say, well, you've got a mental disability. We're going to appoint a guardian. And that guardian is going to make choices about your lives. The fact is that that is one of the most highly abusive mechanisms theoretically to protect a person, but in fact, leaves a person stripped without being able to make choices. The Convention says, the idea of legal competence to make basic choices about your right is an inalienable right. It cannot be taken away. What you need if you have a disability is support. You need support to be able to make your own decision, and that decision rests with you as a fundamental legal right. That is a very progressive model. And I know of no country around the world that has actually yet fully integrated that into their legal systems. Legal systems around the world are going to have to change. In the area of psychiatric institutionalization, there are some very powerful language that says that a person may not be institutionalized on the basis of disability. Under American law, in every single state, a person who is mentally ill and dangerous to themselves or others can be locked up in an institution against their will. According to the High Commissioner and Human Rights, their interpretation of the Disability Convention, that now constitutes a form of discrimination on the basis of disability. It is no longer acceptable. If you're dangerous to yourself or others, but only a person with a disability who's dangerous can be institutionalized and not someone else, that is now a form of disability discrimination. It is going to change very much the way people think about these issues. Yes. MALE_3: How does Sharia law affect us? Eric Rosenthal: That's one area of expertise that I do not have. I couldn't tell you. I did some work in Turkey, and Turkey is a secular society, and yet many of the more traditional societies that I've been to ironically, are ahead of us in a lot of ways simply because the family structures are stronger and there is more of an acceptance that we are going to take care of our disabled family members. Ironically, I find in the more Western countries the particular problems that I'm fighting of segregation from society and abuse in institutions happens. As I've gone to the countries that have never gone through this process of creating these institutions, you have people left in the community with no services whatsoever, but this form of state-sponsored segregation is less evident. I can't tell you about countries under Sharia law. It's not my expertise. As a result of our work, Hungary has abolished the use of cages. That's a very good thing. We have found as a rule, that the horrendous graphic abuse where the state limits someone's rights are much easier to bring an end to than the service system reform that's necessary. In Turkey, we stop 15,000 people a year from getting unmodified ECT. In Hungary, we stop people from getting locked in cages. But the fact of the matter in Hungary, people with major disabilities, mental disabilities, in particular, are still put away in these long-term facilities and they have not reformed. Same is true in Turkey. That reform is going to require ongoing pressure. But I must say, Hungary has now ratified the convention, and there is a top Hungarian expert who's on the new committee created by the Convention on the Rights of Persons with Disabilities, who's got very progressive politics. The law of the land in Hungary says people have a right to community integration. The challenge is now on. We are at unbelievably exciting period in the history of people with disabilities, where countries are recognizing the legal right of individuals with disabilities to be part of society and to provide the supports and services necessary to make that community integration possible. The language could not be better. There's fabulous language in this convention. It's our challenge as activists to hold those government accountable, to work with the locals, to bring about sustainable reform. We know from our experience in the United States it ain't easy. It's going to take many years to do. But there are incredible need right now for support for those activists to learn from our experiences, to learn from our mistakes. Don't do the terrible things that we did. We wasted a lot of years building new bad institutions. We wasted a lot of money painting the walls and leaving people segregated from society. When I go abroad, part of my message is, don't do what we did. Watch out for our mistakes, learn from our mistakes. Go into the most integrated environments you can immediately. There is a terrible shortage of money. International funders have still not recognized that the rights of people with disabilities are a top priority. I can tell you my own organization, I've got a small organization. We've got five staff in Washington, an office in Serbia, an office in Kosovo, a person in Turkey, someone in Paraguay, it's a worldwide problem, and we've got eight or nine people fighting it. With the economic crisis, we have a major budget deficit. We need financial support, and advocacy groups for people with disabilities have been traditionally overlooked by international funders, so it is an enormous challenge to get the support necessary. We're at this absolutely critical stage, and governments need to be held accountable for these violations. FEMALE_2: I have a comment, and I'm just curious of your reaction. I guess I'm an optimist, and I think if people knew what the right thing to do was, they would do it. When you go to a country and they're not doing the right thing, how does the international community build the infrastructure, build the social services, build the intellectual or the educational capacity so people do the right thing locally versus waiting for an American to come to tell them what to do. Eric Rosenthal: Well, I can tell you for certain, we only are able to bring about change where we're able to identify local allies who are going to push for it. We can come and go. The local allies have to be there to fight in the long term. That alliance is critical. In terms of people doing the right thing when they can, the people with disabilities certainly know what the right thing to do is. The family members usually know what the right thing to do is, but the sad fact is that there are often serious vested interests who don't want to do the right thing because their careers are built upon doing the wrong thing. When you've got an institutional system based upon the segregation of people with disabilities, I'll tell you, many times the countries say, well, we can't close down this institution because there are 500 people with jobs there. They'll all lose their jobs. Well-meaning efforts to do the right thing are often blocked by the vested interests of people who don't want to lose their job or don't want to lose their power or have real prejudices to get over about what's possible. In so much of the world, there is still a belief, and I have to say it's here in the United States, too, that if you have a serious disability, major disability, you cannot be part of society. Getting over that hump is a conceptual leap that is a challenge that the disability community needs to face. People with disabilities are their own best ambassadors. I remember, again, in Kosovo, they banned marriage by people with a psychiatric diagnosis. I brought over an American woman who was married, who had a psychiatric diagnosis, and we found a Kosovo we put it on and said, look, here are these very wholesome people who they've got a psychiatric diagnosis and they've got a great family. Shattering those stereotypes is very important. FEMALE_2: Eric, in building your alliances with other groups, can you talk about who we're working with? You mentioned the American Psychiatric Association. Are you working with medical associations? Are you working with families of disabled people, community-based? Undoubtedly, this has to be done on a broad basis. Maybe you could talk a little bit about that. Eric Rosenthal: Sure. First of all, since the United Nations drafting process, the very act of bringing all the world disability leaders together at the UN had a very interesting international impact that the fragmented disability movements of many parts of the world all came together under one roof. As they spent the many years drafting the Convention, they got to know each other, and it has been very fascinating to see that a number of worldwide organizations have been formed. There's a group called Disabled Persons International. Is a group called Inclusion International. It focuses specifically on inclusion of people with intellectual disabilities. There's a world network of users and survivors of psychiatry. There's a group called Rehabilitation International. There's the World Blind Union. There are specific disability groups, and they've all together formed what's called the International Disability Alliance, which the United Nations specifically recognizes. Part of what the UN convention says is there's an obligation under the Convention to consult with organizations of people with disabilities, run by people with disabilities on matters that affect them. The United Nations is now consulting with these disability groups, and on a national level, there's an obligation for each government to confer with organizations run by people with disabilities in their own society. A whole network has been created that wasn't there before, and that is one of the incredibly powerful outcomes of this convention process. My organization is much smaller, tends to target a few different countries for action, we will ally with whoever we can in that particular country. The mental health professionals, when we can get psychiatrists and psychologists and the mental health professionals behind us, they tend to be by far the best organized, the best resourced, and are as individuals, wonderful allies. The truth is more often than not there are opponents. When I was referring earlier to the vested interests that oppose reform, very often those organizations oppose reform. In the case of the American Psychiatric Association recognizing our work, it's an opportunity to open dialogue because change is going to have to come from within. My opportunity to go to the American Psychiatric Association Annual Convention, I consider a welcome open door for a group that really needs to learn that business as usual has just changed in a very big way. When we work in countries, particularly for kids with intellectual disabilities, the family members are fabulous allies. We work with ex-psychiatric patients, we set up advocacy organizations. Again, these groups have been so overlooked, foreign assistance money, civil societies, all the rage, supporting independent civil society, and yet what foreign assistance agency thinks to start organizing ex-psychiatric patients? There are fabulous organizations that we've helped train and support who are now their own advocates who have done investigations, who are holding their governments accountable, who were once locked up in those very same psychiatric facilities, and those are very powerful allies and are the cutting edge of the new international movement. Mainstream human rights organizations, in many ways, were dragged kicking and screaming into this. In Latin America, we've had some very good alliances with mainstream human rights groups who have taken a much more progressive attitude towards this than in other parts of the world. It's a mixed bag of which of the mainstream human rights groups will or will not take on this issue. Amnesty International and Human Rights Watch, the two biggest in the United States, were very hesitant to go into this area and are only now for the first time with the convention, creating projects in this area. They're definitely not at the cutting edge, but I'm very pleased to hear that they are now creating some projects. It's something where I'm expecting another seismic shift in the established international community as a result of this convention. I think right up front, there was a question. In terms of work in the United States, we have not done much work in the United States in part because as a seven-person organization or nine-person we're trying to deal with much of the world where there's no advocacy, and the fact that there is an established advocacy community here has meant that we've pretty much kept I will tell you, and since this is webcast, I won't be too specific, but we are now doing an investigation into some abuses in the United States that would curl your toes. Some abuses that are worse than anything I've seen anywhere in any other country. We are planning to file a complaint, as you said, with the Committee Against Torture and possibly with the Inter-American Commission on Human Rights of abuses in the United States. The United States need to be held accountable to the same standards as others. In a country with tremendous resources and a fabulous disability community, our legal system has failed in a number of very serious ways, and some terrible abuses are going on here. Well, I think we're winding down here. I'll just thank you very much. It's a pleasure to meet you and talk to you and look forward to being in touch with you all. As hopefully future human rights activists, all of you, I hope that you will work with us, incorporate this into the work that you do, and provide us with any support you possibly can. Thank you very much. MALE_4: As a final note, I just want to encourage you to take one extra minute and fill out the evaluations. Also, there is a sign-up sheet on the back for the Disabled Students Cultural Center and also for the Program in Human Rights and Health, if you'd like to receive email announcements and this thing. Kirk Allison, the director of the Program in Human Rights and Health in the School of Public Health, and it's been a real pleasure to be able to have Eric here. Also, it's been a real pleasure to be working with Luka and also with Rachel and the Disabled Cultural Center, and invite you to visit their office sometime on Coffman Union on the third floor, I think. FEMALE_3: Second floor. MALE_4: Second floor. Thank you very much. Eric will be here for conversation. [APPLAUSE]