"But what if nobody's going to sit down and have a real conversation with you?" Service user/survivor perspectives on human rights

Purpose: The purpose of this paper is to discuss human rights assessment and monitoring in psychiatric institutions from the perspectives of those whose rights are at stake. It explores the extent to which mental health service user/psychiatric survivor priorities can be addressed with monitoring instruments such as the WHO QualityRights Tool Kit. Design/methodology/approach: The paper is based on the outcomes of a large-scale consultation exercise with people with personal experience of detention in psychiatric institutions across 15 European countries. The consultation took place via one focus group per country and extended to a total of 116 participants. The distinctive characteristic of this research is that it imparts an insider perspective: both the research design and the qualitative analysis of the focus group discussion transcripts were done by a social researcher who shared the identity of service user/survivor with the participants. Findings: The paper highlights human rights issues which are not readily visible and therefore less likely to be captured in institutional monitoring visits. Key issues include the lack of interaction and general humanity of staff, receipt of unhelpful treatment, widespread reliance on psychotropic drugs as the sole treatment and the overall impact of psychiatric experience on a person's biography. Research limitations/implications: Because of the way participants were recruited, the research findings do not offer a representative picture of the human rights situation in particular countries. They point clearly, however, to new directions for human rights research in the psychiatric context. Originality/value: This paper demonstrates the indispensability of experiential knowledge for not only securing and improving but also extending the understanding of human rights standards in psychiatry.