The Convention on the Rights of Persons with Disabilities

In 2013, Norway ratified the Convention on the Rights of Persons with Disabilities (CRPD) from 2008 (United Nations Association of Norway, 2019). Mental health illnesses are regarded disabilities in this matter, thus people treated within Norwegian mental healthcare should be protected by the CRPD. Kjersti Skarstad, a Norwegian scholar within political science, makes an interesting note regarding the languages used in the CRPD, especially for those with interests in discourses and in dis/ability studies. The English version of the convention stays true to the term ‘person with disability’, whereas the Norwegian translations makes use of two different approaches: 1) ‘personer med nedsatt funksjonsevne’ [persons with reduced capabilities for functioning], and 2)

‘personer med funksjonshemming’ [persons with inhibited functioning], but the latter is only used for describing situations in which cultural barriers make the ‘dis/ability’

an actual problem (Skarstad, 2019). Skarstad argues that the latter understanding of disability is clearly more in line with the general content of the CRPD.

The Human Rights convention from 1948 targets all people, thus people with disabilities should really have been protected by the convention in the first place. Unfortunately, this has not been the reality for people with disabilities, who have been exposed to more comprehensive violations to the Human Rights. And The CRPD was eventually decided, due to both an increased awareness about the situation and political pressure from user organisations of people with disabilities (Skarstad, 2019). Although the situation for people with disabilities has been much worse in the past, it is still quite horrific all around the globe; still in modern times there have been examples of medical experimentation on persons with disabilities, and people are sometimes restrained with chains (Skarstad, 2009).

Also in Europe there are still countries in which violence against people with disabilities are considerable acceptable in institutions (Skarstad, 2019). In Norway people with disabilities are exposed to forced sterilisation and forced abortions, and according to Skarstad (2019), people with disabilities do still not access to the same information, services, and participation due to scarce facilitation. For instance, at least four people with disabled eyesight met challenges in the recent Norwegian election, because local facilities were not adequately adapted, and because the responsible staffs were not sufficiently educated about the rights for people with disabilities (Tvilde, 2019). Only about 20 per cent of Norwegian elementary schools are properly adapted for people with reduced mobility. And according to previous court cases, sexual assaults towards people with mental health disorders or intellectual disabilities receive milder verdicts

than normal (Skarstad, 2019). According to the CRPD information that is meant for the general population should be made available, for instance by adapting the formats to the premises of the users. A contemporary issue worth mentioning is the current digitalisation of the welfare services that seems to make it much harder for people with disabilities to receive their rightful economical transactions (e.g. Fjeldstad, 2019;

Hansen, Lundberg & Syltevik, 2017; Mathisen, 2018).

In Norway, 85 000 people with disabilities want to work, but do not have the opportu-nity (Skarstad, 2019). Through working as a music therapist for people with challenges within mental health and substance abuse, I have met lots of people who could have contributed to society in many ways, if the circumstances were adapted properly. I have also met many people who have been able to work, due to small adaptions such as reduced workweeks and flexible hours. In several ways, the CRPD is meant to protect participation in society for people with disabilities, including participation in the cultural life of society (Skarstad, 2019). As a working music therapist, one of many different weekly tasks, at the moment, is to order the transport for one of the participants, and to adapt the session so that it corresponds with the transport possibilities. At the time, this gesture is necessary for the participant’s ability to participate in music therapy.

When the CRPD stresses that services need to be adapted for persons with disabilities, they also give some description as to how far one is supposed to go to meet the neces-sary accommodations (excerpt from Article 2):

“Reasonable accommodation” means necessary and appropriate modification and adjustments not imposing a disproportionate or undue burden, where needed in a particular case, to ensure to persons with disabilities the enjoyment or exercise on an equal basis with others of all human rights and fundamental freedoms. (United Nations, 2008)

Terms as ‘disproportionate’ and ‘undue burden’ imply that one should indeed go quite far when prioritizing funds and effort for adapting the circumstances for people with disabilities, in order to answer to the Human Rights.

National states that have ratified the CRPD are obliged to ensure the Human Rights, and the responsibility lies with the government. Skarstad (2019) sum up two important responsibilities for national states, (based on article 4): 1) Ensure rights are included equally for every group in politics and legislations, and 2) Ensure that different groups are taken into account through accommodation and measures that guarantee equal treatment in practice. Thus, it is a concern on a national level if persons in mental healthcare experience violations to the CRPD. Additional international conventions are

ratified by Norway and thus shape Norwegian legislations; the ‘Act relating to equality and a prohibition against discrimination (Equality and Anti-Discrimination Act)’, impose measures of accommodation for all public authorities, employers, and others, so that no group is discriminated or kept outside (Equality and Anti-Discrimination Act, 2017;

Skarstad, 2019).

Among eight central principals for the CRPD, three of these seem especially relevant for this study (from Article 3):

(a) Respect for inherent dignity, individual autonomy including the freedom to make one’s own choices, and independence of persons;

(c) Full and effective participation and inclusion in society;

(f) Accessibility; (United Nations, 2008)

Regarding compulsory mental healthcare in specific, the first (a) of the mentioned prin-cipals are perhaps the most obviously relevant one. The national state is responsible for ensuring individual autonomy and self-determination for people, and is obliged to go a long way doing so. Regarding the first principle (a), Skarstad (2019) points out that without the understanding and respect for the intrinsic value of every human being, we get much closer of treating human beings as objects (my translation): ‘One of the main reasons for the widespread violations against people with disabilities is that the violations are not understood as wrong, but rather as natural and legitimate discrimi-nation due to biological and medical differences’ (Skarstad, 2019, p. 82). But as a music therapist I also value highly the accessibility (c) - and possibilities for participation (f), for those in need for potential health promoting services and activities, such as accom-modated music activities. Access to- and accommodation of music activities will also be a relevant perspective later on in this study, when discussing the user experiences portrayed in chapter six. The right to participate in cultural activities, leisure time activities, and sports, are further outlined in Article 30 of the CRPD (United Nations, 2008; Skarstad, 2019). The right to participate includes accommodated transportation to such activities if necessary.

The article 4 of the CRPD denotes that user organisations are involved in decision-mak-ings and accommodations to ensure that necessary considerations are being made, and that professionals working with people with disabilities are educated about the CRPD.

For music therapists both of these measures may prove relevant in order to provide the best services as possible. I would even like to insist that information about the CRPD must be part of the educational programs for music therapists. And participating

with user organizations may indeed provide useful insight for music therapists in both research and practice.