This presentation will give a short introduction to a Human Rights-Based approach (RHBA) and discuss its potential value for children of parents with mental illness and their parents. The first part will define what a HRBA is and explain what are some of its principles. Secondly, the application of a HRBA in the specific context of mental health will be briefly discussed in reference to the UN Principles for the Protection of Persons with Mental Illness and the Improvement of Mental Health Care (1991) and to the UN Convention on the Rights of Persons with Disabilities (2006). Thirdly, the presentation will move on to the rights of children, as supported by the UN Conventions on the Rights of the Child (UNCRC) (1989), and their implications for children of parents with mental illness. This will constitute the main part of the presentation as the articles from the UNCRC that are most relevant to children of parents with mental illness will be briefly presented along with their implications in the context of services and programs offered to families in which a parent has a mental illness. The presentation will end with some concluding comments and implications, as well as some examples of applications, such as Charters of Rights. A discussion will follow on the relevance and benefits of a HRBA for children of parents with mental illness and on ways in which services and programmes could or should be adapted or changed in order to incorporate the principles of a HRBA.

1. Christophe Bedeaux, BA-Applied Human Sciences , Research
Assistant,
Concordia University, Montreal, QC, Canada
1

2. Objectives
Overall goal: provide an introduction to Human
Rights-Based Approaches (HRBA). Focus on
children;
1) Explain what constitutes a Human Rights-Based
Approach (HRBA);
2) Identify key international human rights conventions
and articles relevant to families in which a parent has
a mental illness;
3) Discuss the implications of these articles for services
and programs for children of parents with mental
illness (discussion period).
2

3. Plan of the Presentation
1) Definition and principles of a HRBA;
2) Rights of parents with a mental illness
(MI);
3) Rights of children: the UN
Convention on the Rights of the
Child;
4) Conclusion and implications;
5) Discussion 3

4. What is a HRBA?
 “A human rights-based approach entails
consciously and systematically paying
attention to human rights in all aspects of
programme development.” (UNFPA and
Harvard School of Public Health, 2010, p. 25);
 A HRBA is more holistic, empowering, and
universal, than traditional needs-based
approaches, addresses root-causes, and is more
long-term (Desai, 2010);
 ≠ Evidence Based Approaches. 4

5. Two Key Principles of a HRBA (of 3)
1. All programmes “should further the realisation of human
rights”;
2. All the phases of development of a programme should be
guided by human rights principles. These principles are:
 Universality and inalienability;
 Indivisibility;
 Inter-dependence and inter-relatedness;
 Non-discrimination and equality;
 Participation and inclusion;
 Accountability and the rule of law.
(Stamford Interagency Workshop on a Human Rights-Based
approach in the Context of UN Reform, 2003).
5

6. The Rights of Parents
Convention on the Rights of Persons with Disabilities
 Article 1 – Purpose
“Persons with disabilities include those who
have long-term physical, mental, intellectual
or sensory impairments which [...] may hinder
their full and effective participation in
society [...].” (UN General Assembly, 2006).
6

7.  Article 23 - Respect for home and the family
2. “States Parties shall ensure the rights and
responsibilities of persons with disabilities, with regard
to guardianship, wardship, trusteeship, adoption of
children or similar institutions [...]; in all cases the
best interests of the child shall be paramount.
States Parties shall render appropriate assistance
to persons with disabilities in the performance of
their child-rearing responsibilities.” (UN General
Assembly, 2006).
4. relates to separation of children from parents :
disability in itself not a sufficient basis for separation
of child from parents. 7

8.  Principle 1 Fundamental freedoms and basic rights
“1. All persons have the right to the best available mental
health care […].
2. All persons with a mental illness, or who are being
treated as such persons, shall be treated with humanity and
respect for the inherent dignity of the human person.
4. There shall be no discrimination on the grounds of
mental illness[...].” (UN General Assembly, 1991).
 Principle 2 Protection of minors : “Special care should
be given [...] to protect the rights of minors [...].”
 Principle 11 Consent to treatment (16 articles).
8
Principles for the Protection of Persons with Mental
Illness and the Improvement of Mental Health Care

9. The Rights of Children:
The UN Convention on the Rights of the Child (UNCRC)
 Articles can be divided into four categories (UNICEF, nd.):
1. Guiding principles: A2 Non-discrimination, A3 Best
interests of the child, A12 Respect for child’s views;
2. Rights of protection: A4 Protection of rights, A19
Protection from all forms of violence;
3. Rights of participation: A13 Freedom of expression, A15
Freedom of association, A17 Access to information;
4. Provision, or survival and development rights:
Define parents and governments responsibilities
regarding the upbringing and development of
children, health, standards of living, and leisure, play, and
culture, among others.
9

10. Guiding Principles
 Article 3: the bests interests of children should
prevail in all decisions affecting them;
 How can we determine the bests interests of children?
 Article 12: “1. States Parties shall assure to the child
who is capable of forming his or her own views the
right to express those views freely in all matters
affecting the child, the views of the child being
given due weight in accordance with the age and
maturity of the child.” (UN General Assembly, 1989).
10

11. Relevance and Implications
 Children of parents with MI need, and have a right, to give
their opinions , share their experiences, and be heard (Gray
& Robinson, 2009; Monds-Watson, Manktelow, &
McColgan, 2010; Mordoch, 2010);
 Possible discrepancies between what children want or need
and what parents and professionals may want for them
(Gladstone, Boydell, Seeman, & McKeever, 2011);
 Children need to be more directly involved in research
concerning them (Gladstone, Boydell, & McKeever, 2006);
 Professionals should consult children of parents with MI in
all decisions that affect them (Gladstone, Boydell, &
McKeever, 2006, Mordoch, 2010).
11

12. Rights of Protection
Article 19:
“1. States Parties shall take all appropriate […] measures to
protect the child from all forms of physical or mental
violence, injury or abuse, neglect or negligent
treatment, maltreatment or exploitation […] while in the
care of parent(s), legal guardian(s) or any other person who
has the care of the child.
2. Such protective measures should, as appropriate, include
effective procedures for the establishment of social
programmes to provide necessary support for the child
and for those who have the care of the child, as well as
for other forms of prevention […].” (UN General
Assembly, 1989)
12

13. Relevance: Types of Maltreatment
Sample (Studies)
Only mothers
Neglect Physical
Abuse
Emotional
maltreatment
Child protection (Lewin & Abdrbo,
2009). N = 122, % of cases 59
8.2 + 10.7
both
X
Child protection
(Kohl, Jonson-Reid, & Drake, 2011)
N = 4,895 dyads, % of cases.
67 26 X
Hospitalized mothers
(Dipple, Smith, Andrews, & Evans,
2002) N = 65 children separated, %
54
emotional
50 physical
22 18.5
Child protection,
(Westad &
McConnell, 2012)
% of cases reported
MMI, n =
2,272 47 22 36
NMMI, n =
9,290
39 35 21
13*MMI = Maternal Mental Illness; NMMI = No Maternal Mental Illness

14. Implications
 Increased risk of emotional and behavioral problems in
children of parents with MI importance of early
interventions to support mothers with MI (Westad &
McConnell, 2012);
 Three issues facing professionals working with families
with parental mental illness (Monds-Watson, et al., 2010):
1. unpredictability of mental illness,
2. psychological impacts on children,
3. stigma and fear associated with child protection
interventions;
 Importance of adequate training of child protection
professionals and of adequate assessment procedures;
 UNCRC as a basis for improving child maltreatment
prevention (ex. participation) (Reading et al., 2009). 14

15. Rights of participation
 Article 13: “1. The child shall have the right to freedom
of expression; this right shall include freedom to
seek, receive and impart information and ideas of
all kinds, […] .” (UN General Assembly, 1989);
 This freedom can be restricted by the rights or
reputations of others;
 Article 17: Governments “shall ensure that the child
has access to information and material from a
diversity of national and international
sources, especially those aimed at the promotion
of his or her social, spiritual and moral well-being
and physical and mental health.” (UN General
Assembly, 1989). 15

16. Relevance and Implications
 Children of parents with MI want to talk about their
experience (Gladstone, et al., 2011), preferably not to a
mental health professional (Cooklin, 2011);
 They also need (and want) information regarding their
parent’s MI (Cooklin, 2011, Gladstone, et al., 2011);
 They usually don’t receive such information
(Cooklin, 2011, Gladstone, et al., 2011, Monds-Watson, et
al., 2010);
Children don’t get an adequate and accurate understanding
of their parent’s MI (Gladstone, et al., 2011).
Need to develop and provide information adapted to
children!!
Ex: itisallright.org, SANE Australia : http://itsallright.org/16

17. Survival and Development Rights in Brief
 Parenting: A5: Respect of the rights, responsibilities, and
duties, of parents; A 18: Parents primary responsible for
upbringing and development of children, and obligation of
assistance from Gov’ts to parents (material, programmes);
 Separation from parents and placement: A9: no
separation except if necessary for bests interests of the
child; A20 & A25: rights concerning placement of children;
 A24: right to the “highest attainable standard of health”;
 A27: right to an adequate standard of living;
 A31: Children’ right “to rest and leisure, to engage in play
and recreational activities appropriate” to their age.
17

18. Implications
 Governments’ responsibility to support parents with
mental illness;
 Separation of child from parent: least preferable
option, children and parents fear of family separation;
 Importance of family preservation services and other
tertiary prevention interventions such as: case
management (giving information and advice, teaching
psychosocial skills, natural support systems and self-
help groups), and psycho-educational group work
(Desai, 2010).
 Right to leisure and play: services needed for children
of parents with mental illness who are young carers. 18

19. Comments on the UNCRC
Dichotomy between children’ and parents’
rights? Not if parents rights include
responsibilities toward their children, or
serve the rights of children
(Reynaert, Bouverne-de Bie, &
Vandevelde, 2009), parenting = process;
Rights of children and parents
complementary.
19

20. Conclusion and Implications
 HRBA = comprehensive (legal) framework for services
and programmes for families with parental mental
illness;
 UN Human Rights Conventions address many, if not
most, of the challenges, needs, and opportunities, of
families in which a parent has a mental illness;
 Those Rights should to be ensured and protected by all
professionals involved with families in which a parent
has a mental illness, in the different settings where they
can apply (mental health services, family
services, schools), and in the different phases or steps of
programmes and services
(research, consulting, planning, delivery, and 20

21. Examples of Applications
 One root/basis of the COPMI Initiative in Australia: the
Report of the National Inquiry into the Human rights of
People with Mental Illness (1993). See Findings And
Recommendations (Inquiry chapters 30 and 31) Children of
Parents with Mental Illness (Chapter 16);
 Charter of Children’s and Young People’s Rights in
Healthcare Services in Australia (Children’s Hospitals
Australasia): http://www.awch.org.au/pdfs/Charter-
Children-Young%20People-Healthcare-Au-version-FINAL-
210911b-web.pdf;
 SA Carers Charter (Government of South Australia, 2006):
http://www.sa.gov.au/upload/franchise/Community%20Su
pport/Final%20Carers%20Charter.pdf 21

22. Suggested Reading
A Rights-Based Preventative Approach for
Psychosocial Well-being in Childhood
(Children's Well-Being: Indicators and
Research)
Murli, Desai, Springer, 1st Edition., 2010,
XXIII, 400 p.
http://www.springer.com/social+sciences/wel
l-being/book/978-90-481-9065-2
22
United Nations Population Fund (UNFPA) and Harvard School of Public
Health, (2010). A Human Rights-Based Approach to Programming: Practical
Information and Training Materials, United Nations Population Fund

23. Discussion Questions
How could a HRBA be adopted or
implemented in the services and
programmes offered to children of
parents with mental illness and to their
parents?
Are there any rights that are not being
fully implemented in services and
programmes?
What would need to be changed?
Any challenges/benefits? 23

24. References
Cooklin, A. (2001). The impact of parental mental health on
children. Gresham College, available at:
http://www.gresham.ac.uk/lectures-and-events/the-impact-of-
parental-mental-health-on-children.
Desai, M., & SpringerLink. (2010). A rights-based preventative
approach for psychosocial well -being in childhood. Dordrecht;
New York: Springer.
Dipple, H., Smith, S., Andrews, H., & Evans, B. (2002). The
experience of motherhood in women with severe and enduring
mental illness. Social Psychiatry and Psychiatric
Epidemiology, 37(7), 336-340.
Gladstone, B., Boydell, K., & McKeever, P. (2006). Recasting
research into children's experiences of parental mental illness:
Beyond risk and resilience. Social Science &
Medicine, 62(10), 2540-2550.
24

25. Gladstone, B. M., Boydell, K. M., Seeman, M. V., & McKeever, P. D.
(2011). Children's experiences of parental mental illness: A
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Gray, B., & Robinson, C. (2009). Hidden children: Perspectives of
professionals on young carers of people with mental health
problems. Child Care in Practice, 15(2), 95-108.
Human Rights and Equal Opportunity Commission, (1993). Report
of the National Inquiry into the Human rights of People with
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Kohl, P. L., Jonson-Reid, M., & Drake, B. (2011). Maternal mental
illness and the safety and stability of maltreated children. Child
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26. Lewin, L., & Abdrbo, A. (2009). Mothers with self-reported axis I
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Reading, R., Bissell, S., Goldhagen, J., Harwin, J., Masson, J., Moyni
han, S., . . . Webb, E. (2009). Promotion of children's rights and
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27. Reynaert, D., Bouverne-de Bie, M., & Vandevelde, S. (2009). A
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Stamford Interagency Workshop on a Human Rights-Based
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Common Understanding of a Human Rights-Based Approach to
Development Cooperation. United Nations.
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the Convention on the Rights of the Child, available at:
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2012].
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Child. General assembly resolution 44/25 of 20 November 1989.
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28. UN General Assembly, (1991). Principles for the Protection of
Persons With Mental Illness and the Improvement of Mental
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http://www2.ohchr.org/english/law/principles.htm [accessed
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28