People with psychosis continue to face abuse, discrimination, and early death, despite global reform efforts to protect their human rights, according to La Trobe University researchers on June 30. An international review published in The Lancet analysed more than 350 research papers spanning 35 years and found a persistent gap between global human rights commitments and the lived experiences of people with psychosis in low- and middle-income countries.
La Trobe Associate Professor of Law and co-lead author Dr. Piers Gooding said people living with psychosis continue to experience widespread human rights violations including coercive treatment, confinement, and systemic discrimination across institutional care and community settings. "In many countries, people with psychosis are still being chained, detained or treated against their will," Gooding said.
Gooding added that "in some settings, coercive practices including involuntary arbitrary detention, sterilisation, and confinement in institutions remain common and are often legally sanctioned." He also noted that individuals from minority groups facing discrimination due to gender, age, ethnicity or socio-economic background tend to experience higher rates of coercion.
Despite many countries signing onto international frameworks such as the United Nations Convention on the Rights of Persons with Disabilities (CRPD), the review shows legal reforms have often failed to translate into meaningful changes for those living with mental ill health or disabilities. The review screened nearly 8,000 records from 1990 to 2025 and highlighted significant health inequalities: People with psychosis who also have chronic health conditions die up to ten or fifteen years earlier than the general population. This disparity is largely attributed to systemic issues related to untreated physical health problems and poorer access to care.
"Integration of mental health care into universal health coverage is vital for improving access to appropriate health services for individuals with psychosis," Gooding said. He pointed out successful models in Latin America such as community-based service scale-up in Chile and legislative reforms in Brazil as evidence that integrating psychosis care into universal healthcare is feasible even where resources are limited.
The review also indicates that people with psychosis are more likely than others to be excluded from employment and housing opportunities. In some countries they may face restrictions on civil rights such as voting, marriage or property ownership. "Psychosis and poverty are also closely linked," Gooding said. "This creates a cycle of socio-economic disadvantage that systemically contributes to—and worsens—mental ill health." He concluded by calling for coordinated legislative policy action aligning national laws with the UN CRPD: "People with personal experience of psychosis must be at the centre of designing services and policies that affect them. Without their voices, reforms will continue to fall short... This is ultimately about dignity, autonomy and equal rights which enable people with psychosis to access appropriate care and lead fulfilling lives in their own communities."
