New Mental Health Law for Egypt

18 May 2009. The Egyptian Parliament adopted in late April 2009 a new law entitled the “Law for the Care of Mental Patients”. Mental health law reform is particularly timely in Egypt given the country’s ratification in April 2008 of the UN Convention on the Rights of Persons with Disabilities, which includes rights provisions for persons with mental health disabilities.  

The civil society organization, the Egyptian Initiative for Personal Rights (EIPR) led a vigorous advocacy campaign to ensure that the new law protects the rights of people with mental health disabilities. The new law includes the following new provisions:
 

• Tight legal criteria specifying the circumstances in which a person can be detained in mental health institutions.
• The right of a detained patient to have the lawfulness of detention reviewed by a local court.
• An obligation upon mental health institutions to notify the public prosecutor within 24 hours of involuntarily admitting a patient.
• A right to consent to treatment for ‘voluntary’ patients.
• A requirement that doctors document and periodically review treatment plans.
• A more restrictive definition of circumstances in which solitary confinement and physical restraints can be used.
• A bill of rights for patients inside mental health facilities.
• An obligation on mental health facilities to inform patients of their rights.
• The creation of a patients’ rights committee in every mental health facility to monitor the human rights of people receiving treatment in those institutions.
• An explicit stipulation of the participation of civil society organizations in these patients’ rights committees.
• A range of sanctions for service providers who violate patients’ rights.
• Monitoring bodies providing an independent review of involuntary admissions.
• The establishment of a mental health fund to ensure sustainable financing for mental health care, including capacity-building for those working in mental health.

The new law obliges the Minister of Health to issue implementing regulations. Although the mental health law is a milestone in human rights protection, there are several provisions which did not make it into the final text. Given the need for the implementing regulations to address these missing elements, EIPR and MDAC are planning to jointly write and publish an analysis of the law against international human rights standards, with suggestions about topics which should be included in the regulations. Among these, are:

• Strict guarantees related to imposing treatment upon ‘involuntary’ patients.
• Increased protections for irreversible treatments such as “electroconvulsive therapy”, psycho-surgery and hormone therapies.
• A ban on the use of sterilization as a method of “treatment” for mental illness.
• A legal obligation on the State to provide to the patient a State-funded attorney to represent detainees in court reviews of the lawfulness of the detention.
• A right for detained patients and their representatives to receive copies of the documentation pertaining to the patient’s condition and detention, in order to fully prepare for the court hearings and to be in a position to challenge abuses.
• A specification that the patient has the right to participate in such court hearings which should be of a truly adversarial nature, the right to challenge evidence presented by the detaining authority, and the right to present evidence including calling witnesses.

For further information MDAC recommends reading EIPR’s January 2009 study Egypt’s New Mental Health Bill: a First Step on the Right Path, to which MDAC contributed, and EIPR press release of 29 April. MDAC and EIPR are planning joint projects to advance the rights of persons with mental health disabilities in Egypt. These projects include the preparation of an analysis of the law and suggestions on the implementing regulations, supporting civil society to monitor the human rights of detainees in mental health institutions, capacity building for civil society organisations on the UN Convention on the Rights of Persons with Disabilities, and strategic litigation.